| David A Tabata D D S Inc | |
|
1413 Foothill Blvd Ste B Laverne CA 91750 | |
| (909) 596-1833 | |
| (909) 593-4722 |
| Full Name | David A Tabata D D S Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1413 Foothill Blvd, Laverne, California |
| Authorized Official Name and Position | David A Tabata (OWNER) |
| Authorized Official Contact | 9095961831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David A Tabata D D S Inc 1413 Foothill Blvd Laverne CA 91750 Ph: (909) 596-1831 | David A Tabata D D S Inc 1413 Foothill Blvd Ste B Laverne CA 91750 Ph: (909) 596-1833 |
| NPI Number | 1285709824 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 03/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285709824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 26542 (California) | Primary |
Tony Daher Dds Inc Dental Clinic Medicare: Medicare Enrolled Practice Location: 1413 Foothill Blvd, #a, Laverne, CA 91750 Phone: 909-596-6779 Fax: 909-593-0969 |