Provider Demographics
NPI:1427092097
Name:VOLLER, RAYMOND JOSEPH (DMD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:VOLLER
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 1:135 N GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-1457
Mailing Address - Country:US
Mailing Address - Phone:724-543-4948
Mailing Address - Fax:
Practice Address - Street 1:135 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-1457
Practice Address - Country:US
Practice Address - Phone:724-543-4948
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021733L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice