Organization
KIATKACHORN RATANATHARATHORN, DDS INC
Active
Other names
Nu Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIATKACHORN RATANATHARATHORN DDS (PRESIDENT)
(312) 375-5671
Entity
Organization
Contact information
Practice address
2420 S AZUSA AVE, WEST COVINA, CA 91792-1512
(626) 810-2691
Mailing address
2420 S AZUSA AVE, WEST COVINA, CA 91792-1512
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
10/30/2022
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