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General NPI Number Information
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NPI Number | 1912195280
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Entity Type | Individual
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Provider Name | DR. TERESA C RABANAL
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Gender | Female
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 7733 PALM ST STE 107
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City | LEMON GROVE
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State | CA
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Zip | 91945-2967
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Country | US
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Telephone | 619-460-1991
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Fax | 619-460-1995
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Provider Business Mailing Address
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Address Line | 1437 SILVER SPRINGS DR
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City | CHULA VISTA
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State | CA
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Zip | 91915-1567
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Country | US
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Telephone | 619-216-3092
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Fax | 619-216-3092
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 54192
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License Number State | CA
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