Individual
RUPPORN PRIYAWAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15911 POMONA RINCON RD STE 120, CHINO HILLS, CA 91709-5567
(909) 497-9449
Mailing address
264 DESERT BLOOM, IRVINE, CA 92618-8872
(951) 999-1239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61647
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
61647
CA
Other
Enumeration date
11/20/2012
Last updated
07/31/2023
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