Provider Demographics
NPI:1790064707
Name:DULEBOHN, RACHEL VICTORIA (DMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:VICTORIA
Last Name:DULEBOHN
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 1:101 BUCHANAN RD UNIT 6TH
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21402-5107
Mailing Address - Country:US
Mailing Address - Phone:410-293-3901
Mailing Address - Fax:
Practice Address - Street 1:101 BUCHANAN RD UNIT 6TH
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21402-5107
Practice Address - Country:US
Practice Address - Phone:410-233-3901
Practice Address - Fax:410-293-4831
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014302122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist