Provider Demographics
NPI:1144432477
Name:R A ASSOCIATES OF CHESHIRE, LLC
Entity type:Organization
Organization Name:R A ASSOCIATES OF CHESHIRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-272-8222
Mailing Address - Street 1:P.O. BOX 628
Mailing Address - Street 2:1090 MERIDEN WATERBURY TURNPIKE
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-272-8222
Mailing Address - Fax:203-272-8270
Practice Address - Street 1:1090 MERIDEN WATERBURY TURNPIKE
Practice Address - Street 2:SUITE 3
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-272-8222
Practice Address - Fax:203-272-8270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT60091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty