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General NPI Number Information
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NPI Number | 1518441237
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Entity Type | Organization
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Legal Business Name | LI QIN DENTAL PRACTICE INC
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 320 8TH ST STE 2D
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City | OAKLAND
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State | CA
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Zip | 94607-4261
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Country | US
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Telephone | 510-688-0087
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Fax |
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Provider Business Mailing Address
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Address Line | 1698 SCENICVIEW DR
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City | SAN LEANDRO
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State | CA
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Zip | 94577-5333
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Country | US
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Telephone | 520-241-3765
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUIXIANG LI QIN
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Credential | DMD
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Telephone | 510-688-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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