Provider Demographics
NPI:1386693729
Name:RAKICH, DUKE MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:DUKE
Middle Name:MICHAEL
Last Name:RAKICH
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 1:9984 BREWSTER LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7571
Mailing Address - Country:US
Mailing Address - Phone:614-761-3853
Mailing Address - Fax:614-761-0934
Practice Address - Street 1:9984 BREWSTER LN
Practice Address - Street 2:SUITE 100
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7571
Practice Address - Country:US
Practice Address - Phone:614-761-3853
Practice Address - Fax:614-761-0934
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice