Individual
DR. RUTH WAUQUA BOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4004 BEYER BLVD, SAN YSIDRO, CA 92173-2099
(619) 662-4100
Mailing address
1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
(619) 662-4100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE00009723
WA
1223P0221X
Pediatric Dentistry
10407
TN
1223P0221X
Pediatric Dentistry
Primary
51668
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q026775
—
TN
Enumeration date
04/23/2007
Last updated
05/24/2024
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