Provider Demographics
NPI:1679797229
Name:RAUSCHENBACH, RICHARD ANTHONY (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANTHONY
Last Name:RAUSCHENBACH
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 1:1300 S GRANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-0418
Mailing Address - Country:US
Mailing Address - Phone:605-338-2163
Mailing Address - Fax:605-331-4057
Practice Address - Street 1:1300 S GRANGE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0418
Practice Address - Country:US
Practice Address - Phone:605-338-2163
Practice Address - Fax:605-331-4057
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM6531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice