Provider Demographics
NPI:1124571864
Name:BAYAN S. RAFEE D.D.S. PA
Entity Type:Organization
Organization Name:BAYAN S. RAFEE D.D.S. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:BAYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-403-3455
Mailing Address - Street 1:155 ROSELAND AVE #6
Mailing Address - Street 2:SUIT #6 ESSEX DENTAL
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006
Mailing Address - Country:US
Mailing Address - Phone:973-403-3455
Mailing Address - Fax:
Practice Address - Street 1:155 ROSELAND AVE
Practice Address - Street 2:SUIT #6 ESSEX DENTAL
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006
Practice Address - Country:US
Practice Address - Phone:973-403-3455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty