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General NPI Number Information
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NPI Number | 1407427826
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Entity Type | Individual
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Provider Name | RAMSEN WARDA
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Gender | Male
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 125 ASCOT DR STE A
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City | ROSEVILLE
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State | CA
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Zip | 95661-3408
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Country | US
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Telephone | 916-786-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 463 PIMENTEL WAY
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City | SACRAMENTO
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State | CA
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Zip | 95831-4551
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Country | US
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Telephone | 916-834-3997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DDS104618
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License Number State | CA
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