Provider Demographics
NPI:1730264813
Name:RAO, SABITA M (DMD)
Entity type:Individual
Prefix:
First Name:SABITA
Middle Name:M
Last Name:RAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 NICOLE CT
Mailing Address - Street 2:APT 1D
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3252
Mailing Address - Country:US
Mailing Address - Phone:781-608-7229
Mailing Address - Fax:
Practice Address - Street 1:1048 UNION ST
Practice Address - Street 2:SUITE#4
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-8600
Practice Address - Country:US
Practice Address - Phone:207-992-2152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice