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General NPI Number Information
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NPI Number | 1609575398
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Entity Type | Organization
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Legal Business Name | RW IMPLANTS & COSMETIC DENTISTRY
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 31654 RANCHO VIEJO RD STE I-1
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-6754
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Country | US
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Telephone | 949-240-4337
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Fax | 949-240-7337
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Provider Business Mailing Address
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Address Line | 31654 RANCHO VIEJO RD STE I-1
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-6754
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Country | US
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Telephone | 949-240-4337
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Fax | 949-240-7337
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Authorized Official
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Title or Position | MANAGER
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Name | SOHANY RIBEROS
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Credential |
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Telephone | 949-240-4337
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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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