Phil Jae Ra, D.D.S. Valid NPI

Individual provider · Dentist · Fontana, CA

NPI

1700901527

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

47551 (CA)

Sex

Male

Sole proprietor

No

Enumerated

2007-03-20

Last updated

2015-05-21