Organization
CHANCHAI SANGSURASAK, DDS INC.
Active
Other names
La Sierra Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANCHAI SANGSURASAK DDS (PRESIDENT)
(951) 354-9550
Entity
Organization
Contact information
Practice address
3410 LA SIERRA AVE, SUITE D, RIVERSIDE, CA 92503-5270
(951) 354-9550
(951) 354-8644
Mailing address
3410 LA SIERRA AVE, SUITE D, RIVERSIDE, CA 92503-5270
(951) 354-9550
(951) 354-8644
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
58501
CA
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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