Provider Demographics
NPI:1699791723
Name:WALTER RAPACZ DDS PC
Entity type:Organization
Organization Name:WALTER RAPACZ DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAPACZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-759-4501
Mailing Address - Street 1:3233 E CHANDLER BLVD
Mailing Address - Street 2:#15
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7297
Mailing Address - Country:US
Mailing Address - Phone:480-759-4501
Mailing Address - Fax:480-704-0841
Practice Address - Street 1:3233 E CHANDLER BLVD
Practice Address - Street 2:#15
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7297
Practice Address - Country:US
Practice Address - Phone:480-759-4501
Practice Address - Fax:480-704-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty