Provider Demographics
NPI:1740581354
Name:DOLORES RAMOS GOLDEN AGE DENTAL HYGIENE GROUP CORPORATION
Entity Type:Organization
Organization Name:DOLORES RAMOS GOLDEN AGE DENTAL HYGIENE GROUP CORPORATION
Other - Org Name:DOLORES RAMOS, GOLDEN AGE DENTAL HYGIENE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:714-773-4768
Mailing Address - Street 1:701 S RAYMOND AVE
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-5201
Mailing Address - Country:US
Mailing Address - Phone:714-773-4168
Mailing Address - Fax:714-773-4195
Practice Address - Street 1:701 S RAYMOND AVE
Practice Address - Street 2:SUITE 3B
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-5201
Practice Address - Country:US
Practice Address - Phone:714-773-4168
Practice Address - Fax:714-773-4195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty