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General NPI Number Information
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NPI Number | 1053889956
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Entity Type | Organization
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Legal Business Name | DEBORA RAYHAN D.D.S., INC.
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 1252 AIRPORT PARK BLVD STE D1
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City | UKIAH
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State | CA
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Zip | 95482-5979
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Country | US
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Telephone | 707-462-8719
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Fax | 707-472-0921
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Provider Business Mailing Address
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Address Line | 1252 AIRPORT PARK BLVD STE D1
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City | UKIAH
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State | CA
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Zip | 95482-5979
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Country | US
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Telephone | 707-462-8719
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Fax | 707-472-0921
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | TONIA PAYNE
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Credential |
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Telephone | 707-462-8719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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