Individual provider · Type 1 NPI

Teerarat Neal Phuatrakoon

Periodontics · Roseville, CA

NPI number 1194619155 Active

Practice location

1623 Santa Clara Dr Ste 100
Roseville, CA 95661-3589

Call (916) 788-1114 Map

Mailing address

PO Box 1266
Rancho Cucamonga, CA 91729-1266

Specialties and licenses

TaxonomyCodeLicense
Periodontics Primary 1223P0300XDDS107567 (CA)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1194619155

Teerarat Neal Phuatrakoon's National Provider Identifier is 1194619155, issued on Jun 4, 2025. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Roseville, CA. The record was last updated on Nov 24, 2025.