Provider Demographics
NPI:1841250065
Name:RAMOS, THERESA M (DMD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:M
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 EAST 16TH
Mailing Address - Street 2:SUITE 6
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-9179
Mailing Address - Country:US
Mailing Address - Phone:909-946-8441
Mailing Address - Fax:909-946-8291
Practice Address - Street 1:1125 EAST 16TH
Practice Address - Street 2:SUITE 6
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91784-9179
Practice Address - Country:US
Practice Address - Phone:909-946-8441
Practice Address - Fax:909-946-8291
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice