Provider Demographics
NPI:1568899284
Name:RAFALSKI, JEFFREY T (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:T
Last Name:RAFALSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 W LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020
Mailing Address - Country:US
Mailing Address - Phone:619-463-4459
Mailing Address - Fax:619-444-0668
Practice Address - Street 1:119 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:619-463-4459
Practice Address - Fax:619-444-0668
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62692122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist