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Organization
DR PABLO ENRIQUE LICIAGA DDS
Active
Organization
DR PABLO ENRIQUE LICIAGA DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PABLO ENRIQUE LICIAGA DDS (DENTIST)
(619) 224-2986
Entity
Organization
Contact information
Practice address
2115 BACON ST, SAN DIEGO, CA 92107
(619) 224-2986
(619) 224-2982
Mailing address
2115 BACON ST, SAN DIEGO, CA 92107
(619) 224-2986
(619) 224-2982
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49365
CA
Other
Enumeration date
11/28/2006
Last updated
01/28/2015
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