MEDICARE: ALAN RASKAS 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	22DI00874100	NJ

General Provider Information

NPI Number	:	1578738845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN RASKAS DDS PA

Provider Business Mailing Address
First Line	:	2 SPLIT ROCK DR
Second Line	:	SUITE 10
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-1244
Country	:	US
Telephone Number	:	856-424-3335
Fax Number	:	856-424-8753

Provider Business Practice Location Address
First Line	:	2 SPLIT ROCK DR
Second Line	:	SUITE 10
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-1244
Country	:	US
Telephone Number	:	856-424-3335
Fax Number	:	856-424-8753

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MS. KATHLEEN ARMSTRONG
Credential	:
Telephone Number	:	856-424-3335

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	04/28/2008

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