Provider Demographics
NPI:1043556426
Name:RANIA N. REFAAT, DDS, A PROF. DENTAL CORP
Entity type:Organization
Organization Name:RANIA N. REFAAT, DDS, A PROF. DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:REFAAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-989-1758
Mailing Address - Street 1:304 N. MOUNTAIN AVE.
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786
Mailing Address - Country:US
Mailing Address - Phone:909-989-1758
Mailing Address - Fax:909-989-9874
Practice Address - Street 1:304 N. MOUNTAIN AVE.
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-989-1758
Practice Address - Fax:909-989-9874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46326261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental