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Organization
RALPH B WAUGH DDS MD INC
Active
Organization
RALPH B WAUGH DDS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH B WAUGH DDS MD (PRESIDENT OF CORPORATION)
(661) 948-5061
Entity
Organization
Contact information
Practice address
119 S GOLD CANYON, RIDGECREST, CA 93555
(760) 375-1511
(760) 375-5980
Mailing address
119 S GOLD CANYON, RIDGECREST, CA 93555
(760) 375-1511
(760) 375-5980
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
14900
CA
208600000X
Surgery Physician
A22524
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A22540
—
CA
01
—
14900
DENTAL
CA
Enumeration date
08/29/2007
Last updated
08/29/2007
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