Provider Demographics
NPI:1730226648
Name:DR'S FORD, GUTER, & RAI, LTD
Entity type:Organization
Organization Name:DR'S FORD, GUTER, & RAI, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-499-6886
Mailing Address - Street 1:5720 GREENWICH RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-499-6886
Mailing Address - Fax:757-499-3464
Practice Address - Street 1:5720 GREENWICH RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-499-6886
Practice Address - Fax:757-499-3464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223S0112X
VA0401-4102561223S0112X
VA0401-4102391223S0112X
VA0401-0060241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty