Provider Demographics
NPI:1720123193
Name:RABIN, PHILIP N (DDS)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:N
Last Name:RABIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 S HOLMDEL RD # 383
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2130
Mailing Address - Country:US
Mailing Address - Phone:732-946-4644
Mailing Address - Fax:732-946-2546
Practice Address - Street 1:12 S HOLMDEL RD # 383
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2130
Practice Address - Country:US
Practice Address - Phone:732-946-4644
Practice Address - Fax:732-946-2546
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ73161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice