Provider Demographics
NPI:1528382769
Name:RITA C. SOTO DDS, INC.
Entity Type:Organization
Organization Name:RITA C. SOTO DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-771-8334
Mailing Address - Street 1:78900 AVENUE 47
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2070
Mailing Address - Country:US
Mailing Address - Phone:760-771-8334
Mailing Address - Fax:760-771-8337
Practice Address - Street 1:78900 AVE 47
Practice Address - Street 2:SUITE 110
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2070
Practice Address - Country:US
Practice Address - Phone:760-771-8334
Practice Address - Fax:760-771-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440921223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1164595260OtherSOLE PROPRIETORSHIP