Provider Demographics
NPI:1003239856
Name:RABBAN, RANA ADEL
Entity Type:Individual
Prefix:DR
First Name:RANA
Middle Name:ADEL
Last Name:RABBAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:RANA
Other - Middle Name:ADEL
Other - Last Name:RABBAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:26561 W 12 MILE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-5693
Mailing Address - Country:US
Mailing Address - Phone:248-864-7400
Mailing Address - Fax:
Practice Address - Street 1:26561 W12 MILE RD., SUITE 105
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-864-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021126122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist