Provider Demographics
NPI:1306223623
Name:RONALD L. BARBANELL, DDS A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:RONALD L. BARBANELL, DDS A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:V
Authorized Official - Last Name:BARBANELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-923-0038
Mailing Address - Street 1:8207 3RD ST
Mailing Address - Street 2:#102
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3729
Mailing Address - Country:US
Mailing Address - Phone:562-923-0038
Mailing Address - Fax:562-923-8563
Practice Address - Street 1:8207 3RD ST
Practice Address - Street 2:#102
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3729
Practice Address - Country:US
Practice Address - Phone:562-923-0038
Practice Address - Fax:562-923-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221291223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty