| NPI | 1942263199 |
|---|---|
| Former Name | CHAD RANDALL RAPER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-02-1631) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 36875) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-01-05 |