MEDICARE: DR. RICHARD G. RAAD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D13803	MI

General Provider Information

NPI Number	:	1053310730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD G. RAAD DDS

Provider Business Mailing Address
First Line	:	50505 SCHOENHERR RD
Second Line	:	STE 170
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48315-3141
Country	:	US
Telephone Number	:	586-530-0689
Fax Number	:

Provider Business Practice Location Address
First Line	:	41400 DEQUINDRE RD
Second Line	:	SUITE #101
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-3763
Country	:	US
Telephone Number	:	586-739-1111
Fax Number	:	586-726-9441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	03/11/2016

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