MEDICARE: DR. JAMES GEORGE RAFAEL DDS, PA

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	5879	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245359827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES GEORGE RAFAEL DDS, PA

Provider Business Mailing Address
First Line	:	2211 DELANEY DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-5263
Country	:	US
Telephone Number	:	336-226-4714
Fax Number	:	336-221-1712

Provider Business Practice Location Address
First Line	:	2211 DELANEY DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-5263
Country	:	US
Telephone Number	:	336-226-4714
Fax Number	:	336-221-1712

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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