Provider Demographics
NPI:1306929815
Name:SIE, RATNA N (DDS)
Entity type:Individual
Prefix:DR
First Name:RATNA
Middle Name:N
Last Name:SIE
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 1:43625 MISSION BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5852
Mailing Address - Country:US
Mailing Address - Phone:510-656-0686
Mailing Address - Fax:
Practice Address - Street 1:43625 MISSION BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5852
Practice Address - Country:US
Practice Address - Phone:510-656-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA404951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice