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General NPI Number Information
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NPI Number | 1518479757
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Entity Type | Organization
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Legal Business Name | RWIGEMA DENTAL CORPORATION
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 10/27/2017
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Provider Practice Location Address
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Address Line | 3025 E AVENUE S STE A14
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City | PALMDALE
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State | CA
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Zip | 93550-2472
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Country | US
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Telephone | 661-265-7694
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Fax |
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Provider Business Mailing Address
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Address Line | 3025 E AVENUE S STE A14
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City | PALMDALE
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State | CA
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Zip | 93550-2472
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Country | US
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Telephone | 661-265-7694
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DR. JEAN-PIERRE MUGABA RWIGEMA
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Credential | DDS
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Telephone | 661-265-7694
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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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