Provider Demographics
NPI:1649498379
Name:CABANAS, CAROL LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LYNN
Last Name:CABANAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:72027 HIGHWAY 111
Mailing Address - Street 2:SUITE C
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-340-5155
Mailing Address - Fax:760-340-1607
Practice Address - Street 1:72027 HIGHWAY 111
Practice Address - Street 2:SUITE C
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-340-5155
Practice Address - Fax:760-340-1607
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA413621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice