Provider Demographics
NPI:1477924975
Name:TOLEDO, RYAN CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:TOLEDO
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 1:23224 WESTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5313
Mailing Address - Country:US
Mailing Address - Phone:909-327-7366
Mailing Address - Fax:
Practice Address - Street 1:326 N RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5926
Practice Address - Country:US
Practice Address - Phone:909-875-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65079122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist