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General NPI Number Information
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NPI Number | 1942540943
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Entity Type | Organization
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Legal Business Name | RAYGADA & RABANAL DDS INC.
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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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 |
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Provider Business Mailing 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 |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAVIER RAYGADA
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Credential | DDS
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Telephone | 619-948-8953
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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 | 50976
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License Number State | CA
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