Provider Demographics
NPI:1285950592
Name:JORDACHE, RAZVAN DUMITRU (DMD)
Entity type:Individual
Prefix:
First Name:RAZVAN
Middle Name:DUMITRU
Last Name:JORDACHE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 KEMPTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-1503
Mailing Address - Country:US
Mailing Address - Phone:508-999-2727
Mailing Address - Fax:508-999-2331
Practice Address - Street 1:1212 KEMPTON ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1503
Practice Address - Country:US
Practice Address - Phone:508-999-2727
Practice Address - Fax:508-999-2331
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice