Provider Demographics
NPI:1356481683
Name:BUONCRISTIANI, RALPH D (DDS)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:D
Last Name:BUONCRISTIANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2023
Mailing Address - Country:US
Mailing Address - Phone:310-315-1034
Mailing Address - Fax:310-315-0077
Practice Address - Street 1:2020 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2023
Practice Address - Country:US
Practice Address - Phone:310-315-1034
Practice Address - Fax:310-315-0077
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist