Provider Demographics
NPI:1104500107
Name:RAPER, ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:RAPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 SWEETCLOVER ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-7808
Mailing Address - Country:US
Mailing Address - Phone:316-371-4649
Mailing Address - Fax:
Practice Address - Street 1:647 COUNTRY CLUB TER
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2450
Practice Address - Country:US
Practice Address - Phone:785-841-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS621121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice