Provider Demographics
NPI:1730195520
Name:RAFAIL, FRANK ELIAS (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ELIAS
Last Name:RAFAIL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11738 CARNEL MOUNTAIN ROAD
Mailing Address - Street 2:STE 170
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128
Mailing Address - Country:US
Mailing Address - Phone:858-675-1180
Mailing Address - Fax:858-675-0663
Practice Address - Street 1:11738 CARMEL MOUNTAIN RD
Practice Address - Street 2:STE 170
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4634
Practice Address - Country:US
Practice Address - Phone:858-675-1180
Practice Address - Fax:858-675-0663
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice