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General NPI Number Information
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NPI Number | 1942515952
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Entity Type | Individual
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Provider Name | TIMOTHY C RAUCH DDS
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Gender | Male
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 930 SUNNYSLOPE RD SUITE D4
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City | HOLLISTER
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State | CA
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Zip | 95023-5615
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Country | US
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Telephone | 831-637-1675
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Fax |
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Provider Business Mailing Address
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Address Line | 222.5 SAN AUGUSTINE WAY
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066
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Country | US
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Telephone | 505-377-7012
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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 | DD3313
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License Number State | NM
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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 | 65071
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License Number State | CA
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