Provider Demographics
NPI:1720828130
Name:RATHKE, MARGARET (DDS)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:RATHKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4631 S M 88 HWY
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:MI
Mailing Address - Zip Code:49615-9111
Mailing Address - Country:US
Mailing Address - Phone:231-533-8712
Mailing Address - Fax:
Practice Address - Street 1:4631 S M 88 HWY
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:MI
Practice Address - Zip Code:49615-9111
Practice Address - Country:US
Practice Address - Phone:231-533-8712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901602148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist