Individual
MR. RAFAEL BARRANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
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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