Provider Demographics
NPI:1902234610
Name:RAFFI MERJIK DMD, INC.
Entity Type:Organization
Organization Name:RAFFI MERJIK DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFFI
Authorized Official - Middle Name:
Authorized Official - Last Name:MERJIK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-934-2666
Mailing Address - Street 1:26 HARTFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:N SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1865
Mailing Address - Country:US
Mailing Address - Phone:401-934-2666
Mailing Address - Fax:
Practice Address - Street 1:26 HARTFORD PIKE
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1865
Practice Address - Country:US
Practice Address - Phone:401-934-2666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN03196122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty