Provider Demographics
NPI:1770260549
Name:AL FAYTAROUNI, RABIH (DMD)
Entity type:Individual
Prefix:
First Name:RABIH
Middle Name:
Last Name:AL FAYTAROUNI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 SAINT MARKS AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2836
Mailing Address - Country:US
Mailing Address - Phone:551-223-0000
Mailing Address - Fax:
Practice Address - Street 1:3333 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2691
Practice Address - Country:US
Practice Address - Phone:732-234-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029840001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice