Provider Demographics
NPI:1083893580
Name:CABANAS AND LEE DENTAL CORPORATION
Entity Type:Organization
Organization Name:CABANAS AND LEE DENTAL CORPORATION
Other - Org Name:RANCHO MIRAGE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CABANAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-340-5155
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:714-845-8500
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:71817 HIGHWAY 111 STE 1
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4487
Practice Address - Country:US
Practice Address - Phone:760-340-5155
Practice Address - Fax:760-340-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty