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Organization
TABERNA DENTAL CORPORATION
Active
Organization
TABERNA DENTAL CORPORATION
Active
Other names
Jacklin Dental Office
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILAGROS LINGAT TABERNA D.M.D. (PRESIDENT)
(408) 946-4815
Entity
Organization
Contact information
Practice address
282 S MAIN ST, MILPITAS, CA 95035-5315
(408) 946-4815
(408) 946-3249
Mailing address
282 S. MAIN ST., MILPITAS, CA 95035-5315
(408) 946-4815
(408) 946-3249
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42500
DENTAL BOARD LICENSE #
CA
Enumeration date
12/21/2007
Last updated
12/21/2007
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