Individual
WARISARA SRIMUANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10470 FOOTHILL BLVD STE 126, RANCHO CUCAMONGA, CA 91730-6945
(909) 989-7888
Mailing address
5895 CEDAR MOUNTAIN DR, ALTA LOMA, CA 91737-7840
(626) 689-9212
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
26239
CA
124Q00000X
Dental Hygienist
Primary
H8696
OR
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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