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General NPI Number Information
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NPI Number | 1609018100
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Entity Type | Organization
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Legal Business Name | MA. THERESA M. RAMOS DMD INC
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 1125 E 16TH ST STE 6
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City | UPLAND
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State | CA
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Zip | 91784-9180
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Country | US
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Telephone | 909-946-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 E 16TH ST STE 6
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City | UPLAND
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State | CA
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Zip | 91784-9180
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Country | US
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Telephone | 909-946-8441
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. THERESA M. RAMOS
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Credential | DMD
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Telephone | 909-946-8441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41471
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License Number State | CA
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