MEDICARE: RON C ABARO DENTAL 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
1	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629741186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RON C ABARO DENTAL CORP

Provider Business Mailing Address
First Line	:	359 W MADISON AVE STE 200
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3456
Country	:	US
Telephone Number	:	619-440-6364
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 W MADISON AVE STE 200
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3456
Country	:	US
Telephone Number	:	619-440-6364
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL BILLING MANAGER
Name	:	FAVIOLA SILVA
Credential	:
Telephone Number	:	323-835-6839

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	07/29/2021

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Directions to “RON C ABARO DENTAL CORP ” Practice Location

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