Provider Demographics
NPI:1366579963
Name:RABANAL, ALEJANDRO ROBERTO (DDS)
Entity type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:ROBERTO
Last Name:RABANAL
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 1:152 ROLLINS AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4008
Mailing Address - Country:US
Mailing Address - Phone:240-669-8268
Mailing Address - Fax:
Practice Address - Street 1:152 ROLLINS AVE STE 204
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4008
Practice Address - Country:US
Practice Address - Phone:240-669-8268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6797122300000X
MD14323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist