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General NPI Number Information
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NPI Number | 1699902791
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Entity Type | Organization
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Legal Business Name | BOBBY L. RABER DMD, PLLC
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 2801 N PLEASANT VIEW DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-3551
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Country | US
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Telephone | 928-443-1400
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Fax | 928-777-8264
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Provider Business Mailing Address
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Address Line | 2801 N PLEASANT VIEW DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-3551
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Country | US
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Telephone | 928-443-1400
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Fax | 928-777-8264
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MARVA COOPER
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Credential | CMPE
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Telephone | 928-443-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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