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NPI Code Detail

MEDICARE: RAEL BERNSTEIN DDS A PROF CORP

MEDICARE: RAEL BERNSTEIN DDS A PROF CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry46245CA

General Provider Information

NPI Number : 1063968477
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAEL BERNSTEIN DDS A PROF CORP
Provider Business Mailing Address
First Line : 2245 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4900
Country : US
Telephone Number : 707-575-7545
Fax Number :
Provider Business Practice Location Address
First Line : 1620 VALLE VISTA AVE
Second Line : STE 200
City : VALLEJO
State : CA
Zip : 94589-2842
Country : US
Telephone Number : 707-552-4940
Fax Number :
Authorized Official
Title or Position : ORTHODONTIST/OWNER
Name : DR. RAEL I BERNSTEIN
Credential : DDS
Telephone Number : 707-575-0600
Provider Enumeration Date : 08/27/2016
Last Update Date : 08/27/2016

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Directions to “RAEL BERNSTEIN DDS A PROF CORP ” Practice Location

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