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General NPI Number Information
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NPI Number | 1972661007
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Entity Type | Individual
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Provider Name | RONALD A MAEDA DDS INC
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 9872 CHAPMAN AVE SUITE 206
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City | GARDEN GROVE
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State | CA
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Zip | 92841-2733
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Country | US
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Telephone | 714-638-5630
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Fax | 714-638-5632
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Provider Business Mailing Address
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Address Line | 9872 CHAPMAN AVE SUITE 206
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City | GARDEN GROVE
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State | CA
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Zip | 92841-2733
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Country | US
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Telephone | 714-638-5630
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Fax | 714-638-5632
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 19358
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License Number State | CA
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