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General NPI Number Information
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NPI Number | 1689606014
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Entity Type | Individual
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Provider Name | LOREN A RAYMOND DMD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4322 CLEVELAND MASSILLON RD
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City | NORTON
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State | OH
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Zip | 44203-5718
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Country | US
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Telephone | 330-825-4549
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Fax | 330-825-7360
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Provider Business Mailing Address
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Address Line | 4322 CLEVELAND MASSILLON RD
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City | NORTON
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State | OH
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Zip | 44203-5718
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Country | US
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Telephone | 330-825-4549
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Fax | 330-825-7360
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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 | 30013345
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License Number State | OH
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