Provider Demographics
NPI:1316091234
Name:ARANDA, RAFAEL (DDS)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:ARANDA
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 1:10905 WURZBACH RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2501
Mailing Address - Country:US
Mailing Address - Phone:210-690-5252
Mailing Address - Fax:210-690-3889
Practice Address - Street 1:10905 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2501
Practice Address - Country:US
Practice Address - Phone:210-690-5252
Practice Address - Fax:210-690-3889
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX164101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX834583OtherINDIVIDUAL PROVIDER