Provider Demographics
NPI:1366892796
Name:RAI, DANNY (DDS)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:RAI
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 1:4302 13TH AVE S
Mailing Address - Street 2:SUITE 10
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3395
Mailing Address - Country:US
Mailing Address - Phone:701-281-8000
Mailing Address - Fax:701-660-1070
Practice Address - Street 1:4302 13TH AVE S
Practice Address - Street 2:SUITE 10
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3395
Practice Address - Country:US
Practice Address - Phone:701-281-8000
Practice Address - Fax:701-660-1070
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist