Provider Demographics
NPI:1366630014
Name:DONALD A RAABE, DDS, INC.
Entity type:Organization
Organization Name:DONALD A RAABE, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:RAABE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-836-9341
Mailing Address - Street 1:33 BAKER BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 BAKER BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3650
Practice Address - Country:US
Practice Address - Phone:330-836-9341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300139591223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty