Provider Demographics
NPI:1003141086
Name:MELANIE M. RABENI DDS, PC
Entity Type:Organization
Organization Name:MELANIE M. RABENI DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RABENI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-746-4856
Mailing Address - Street 1:45 RESNIK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4844
Mailing Address - Country:US
Mailing Address - Phone:508-746-4856
Mailing Address - Fax:508-927-4709
Practice Address - Street 1:45 RESNIK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4844
Practice Address - Country:US
Practice Address - Phone:508-746-4856
Practice Address - Fax:508-927-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18550811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty