Provider Demographics
NPI:1447593579
Name:RAFF, HARRY GREGORY (DMD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:GREGORY
Last Name:RAFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 LINCOLN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2195
Mailing Address - Country:US
Mailing Address - Phone:516-766-6780
Mailing Address - Fax:
Practice Address - Street 1:2940 LINCOLN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2195
Practice Address - Country:US
Practice Address - Phone:516-766-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0427351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice