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General NPI Number Information
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NPI Number | 1912027897
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Entity Type | Individual
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Provider Name | DONNA RACHUBA DMD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 DAWSON ST
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City | MOORESTOWN
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State | NJ
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Zip | 08057-2420
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Country | US
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Telephone | 856-231-7560
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Fax | 856-273-9330
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Provider Business Mailing Address
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Address Line | 117 MERCER ST
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City | WOODBURY HTS
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State | NJ
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Zip | 08097-1437
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Country | US
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Telephone | 609-254-2229
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | NJ
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