Provider Demographics
NPI:1740495118
Name:PACCONE, REBECCA RANKO (DMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RANKO
Last Name:PACCONE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:MARIE
Other - Last Name:RANKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:123 REVERE ST
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4439
Mailing Address - Country:US
Mailing Address - Phone:781-284-6826
Mailing Address - Fax:781-284-1171
Practice Address - Street 1:123 REVERE ST
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4439
Practice Address - Country:US
Practice Address - Phone:781-284-6826
Practice Address - Fax:781-284-1171
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA184041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice