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7071 Indiana Ave Riverside CA 92504 | |
| (714) 363-6928 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7071 Indiana Ave, Riverside, California |
| Authorized Official Name and Position | Raymond S Wang (DOCTOR) |
| Authorized Official Contact | 7143636928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
54 Tundra Irvine CA 92602-1847 Ph: (714) 363-6928 | 7071 Indiana Ave Riverside CA 92504 Ph: (714) 363-6928 |
| NPI Number | 1538630959 |
|---|---|
| Provider Enumeration Date | 12/11/2018 |
| Last Update Date | 02/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538630959 | NPI | - | NPPES |
| 1871904896 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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