Individual
TEERARAT NEAL PHUATRAKOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1623 SANTA CLARA DR STE 100, ROSEVILLE, CA 95661-3589
(916) 788-1114
Mailing address
PO BOX 1266, RANCHO CUCAMONGA, CA 91729-1266
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DDS107567
CA
Other
Enumeration date
06/04/2025
Last updated
11/24/2025
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