Provider Demographics
NPI:1134282106
Name:RUIDERA, VIOLETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIOLETTE
Middle Name:
Last Name:RUIDERA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S GLENDORA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3048
Mailing Address - Country:US
Mailing Address - Phone:626-918-8338
Mailing Address - Fax:626-918-8281
Practice Address - Street 1:415 S GLENDORA AVE
Practice Address - Street 2:STE A
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3048
Practice Address - Country:US
Practice Address - Phone:626-918-8338
Practice Address - Fax:626-918-8281
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice