Provider Demographics
NPI:1386768331
Name:UMALI, RALPH EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:EDWARD
Last Name:UMALI
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 1:16610 BONANZA DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-5732
Mailing Address - Country:US
Mailing Address - Phone:951-780-9405
Mailing Address - Fax:
Practice Address - Street 1:16610 BONANZA DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-5732
Practice Address - Country:US
Practice Address - Phone:951-780-9405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA372991223G0001X
AZ7209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered122300000XDental ProvidersDentist