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General NPI Number Information
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NPI Number | 1841598299
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Entity Type | Organization
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Legal Business Name | RAINCROSS DENTAL
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 7028 INDIANA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-4157
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Country | US
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Telephone | 951-367-1345
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Fax | 951-367-1347
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Provider Business Mailing Address
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Address Line | 7028 INDIANA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-4157
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Country | US
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Telephone | 951-367-1345
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Fax | 951-367-1347
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Authorized Official
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Title or Position | CEO
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Name | CATHERINE NGUYEN
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Credential | DDS
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Telephone | 951-367-1345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 42863
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License Number State | CA
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