Individual
MR. RAFAEL BARRANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
21 GRAND STREET, HARTFORD, CT 06106
(860) 550-7500
(860) 550-7501
Mailing address
21 GRAND STREET, HARTFORD, CT 06106
(860) 550-7500
(860) 550-7501
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
009419
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009419
DENTIST LICENSE
CT
01
—
37242
CONTROLLED SUBSTANCE
CT
Enumeration date
01/26/2006
Last updated
07/08/2007
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