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Trevor Raczkowski
NPI 1972342574 · on the registry since 2024 · sole proprietor
Practice
- Address
- 4770 S Harvard Ave
Tulsa, OK 74135 - Phone
- (918) 215-2858
- Organisation at this address
- Dental Depot Of I-44 & Harvard, Pllc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-05-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma