Provider Demographics
NPI:1063783439
Name:RAYFORD DENTAL, LLP
Entity type:Organization
Organization Name:RAYFORD DENTAL, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:DERR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-443-7524
Mailing Address - Street 1:2211 RAYFORD RD
Mailing Address - Street 2:#113
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1555
Mailing Address - Country:US
Mailing Address - Phone:281-362-1222
Mailing Address - Fax:
Practice Address - Street 1:2211 RAYFORD RD
Practice Address - Street 2:#113
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1555
Practice Address - Country:US
Practice Address - Phone:281-362-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty