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Individual

DR. RUTH WAUQUA BOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

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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