Bol, Ruth Wauqua

Bol, Ruth Wauqua is an individual health care provider with primary practice located at 4004 Beyer Blvd , San Ysidro CA 92173-2099. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Bol, Ruth Wauqua can be contacted via phone (619) 662-4100.

Contact Information

Primary practice address
4004 Beyer Blvd San Ysidro CA 92173-2099
Phone: (619) 662-4100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DE00009723 Washington
Dental Providers / Pediatric Dentistry 1223P0221X 10407 Tennessee
Dental Providers / Pediatric Dentistry 1223P0221X 51668 California

Profile Details

NPI number 1124246376
LBN Legal business name Bol, Ruth Wauqua
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated May 24th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124246376 NPPES
Tennessee MEDICAID Q026775

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