Provider Demographics
NPI:1063279552
Name:JEFF M. PRAIS, D.D.S., INC.
Entity type:Organization
Organization Name:JEFF M. PRAIS, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PRAIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-677-4188
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE B110
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9105
Mailing Address - Country:US
Mailing Address - Phone:951-677-4188
Mailing Address - Fax:951-677-1866
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE B110
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9105
Practice Address - Country:US
Practice Address - Phone:951-677-4188
Practice Address - Fax:951-677-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty