Provider Demographics
NPI:1679706543
Name:STEVEN L. RASNER, DMD, MAGD
Entity type:Organization
Organization Name:STEVEN L. RASNER, DMD, MAGD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MAGD
Authorized Official - Phone:856-692-1180
Mailing Address - Street 1:2106 W LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-3431
Mailing Address - Country:US
Mailing Address - Phone:856-692-1180
Mailing Address - Fax:
Practice Address - Street 1:2106 W LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-3431
Practice Address - Country:US
Practice Address - Phone:856-692-1180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0127351223G0001X
NJDI0169061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty