Provider Demographics
NPI:1518028646
Name:DEVERS, RALPH CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:CHARLES
Last Name:DEVERS
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 1:531 32ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3005
Mailing Address - Country:US
Mailing Address - Phone:510-658-9199
Mailing Address - Fax:510-658-9199
Practice Address - Street 1:531 32ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3005
Practice Address - Country:US
Practice Address - Phone:510-658-9199
Practice Address - Fax:510-658-9199
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice