Individual
DR. KITICHAI RUNGCHARASSAENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
LOMA LINDA UNIVERSITY SCHOOL OF DENTISTRY, DEPARTMENT OF ORTHODONTICS, LOMA LINDA, CA 92350-0001
(909) 558-4616
Mailing address
13063 HELEN DR, REDLANDS, CA 92373-7434
(909) 910-5887
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
45002
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
45002
CA
Other
Enumeration date
03/29/2007
Last updated
01/15/2021
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