Provider Demographics
NPI:1437407475
Name:FLORES, RACHELLE TUMANUT (DMD)
Entity Type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:TUMANUT
Last Name:FLORES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27805 DOGWOOD GLEN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-7326
Mailing Address - Country:US
Mailing Address - Phone:480-394-1777
Mailing Address - Fax:
Practice Address - Street 1:27805 DOGWOOD GLEN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-7326
Practice Address - Country:US
Practice Address - Phone:480-394-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-23
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA617381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice