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General NPI Number Information
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NPI Number | 1922544543
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Entity Type | Organization
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Legal Business Name | RAPTIS ORTHODONTICS
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Dates
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Enumeration Date | 01/07/2017
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Last Update Date | 01/07/2017
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Provider Practice Location Address
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Address Line | 670 EAST RD
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City | BRISTOL
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State | CT
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Zip | 06010-6845
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Country | US
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Telephone | 860-261-7094
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Fax |
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Provider Business Mailing Address
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Address Line | 670 EAST RD
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City | BRISTOL
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State | CT
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Zip | 06010-6845
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. MARKOS RAPTIS
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Credential | DMD, MPH
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Telephone | 860-261-7094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 010211
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License Number State | CT
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