Provider Demographics
NPI:1114451283
Name:DENTAL ARTS OF MAPLE
Entity Type:Organization
Organization Name:DENTAL ARTS OF MAPLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RABBAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-469-3268
Mailing Address - Street 1:6525 WEST MAPLE ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322
Mailing Address - Country:US
Mailing Address - Phone:248-469-3268
Mailing Address - Fax:
Practice Address - Street 1:6525 WEST MAPLE ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322
Practice Address - Country:US
Practice Address - Phone:248-469-3268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental