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General NPI Number Information
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NPI Number | 1598926115
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Entity Type | Individual
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Provider Name | GAIL N RAETHER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 7806 MARKET BLVD
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City | CHANHASSEN
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State | MN
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Zip | 55317-9440
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Country | US
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Telephone | 952-949-1083
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Fax | 952-949-1084
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Provider Business Mailing Address
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Address Line | 26420 OAK RIDGE CIR
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City | SHOREWOOD
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State | MN
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Zip | 55331-7973
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Country | US
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Telephone | 720-308-2162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9704
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN-9704
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License Number State | CO
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