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General NPI Number Information
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NPI Number | 1679216253
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Entity Type | Organization
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Legal Business Name | NOURA FADEL RATEB DDS INC
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 720 BROOKSIDE AVE STE 100
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City | REDLANDS
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State | CA
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Zip | 92373-5189
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Country | US
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Telephone | 909-488-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 720 BROOKSIDE AVE STE 100
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City | REDLANDS
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State | CA
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Zip | 92373-5189
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Country | US
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Telephone | 909-488-0222
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. NOURA SEIF ALLAH AHMED FADEL RATEB
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Credential | DDS FAGD
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Telephone | 585-770-0592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 125K00000X
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Taxonomy Name | Advanced Practice Dental Therapist
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License Number |
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License Number State |
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