Provider Demographics
NPI:1881710317
Name:INFANTE, RAFAEL E (DDS)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:E
Last Name:INFANTE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2939 ALTA VIEW DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-3394
Mailing Address - Country:US
Mailing Address - Phone:619-267-8772
Mailing Address - Fax:619-475-6099
Practice Address - Street 1:13569 POWAY RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4715
Practice Address - Country:US
Practice Address - Phone:858-486-3300
Practice Address - Fax:858-486-5300
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice