Provider Demographics
NPI:1740494525
Name:KUWAHARA, RAY (DDS)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:
Last Name:KUWAHARA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23451 MADISON ST
Mailing Address - Street 2:STE 210
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4785
Mailing Address - Country:US
Mailing Address - Phone:310-378-8342
Mailing Address - Fax:310-378-4672
Practice Address - Street 1:3655 LOMITA BLVD
Practice Address - Street 2:217
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3931
Practice Address - Country:US
Practice Address - Phone:310-378-8342
Practice Address - Fax:310-378-4672
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA199191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics