Individual
DR. BERNARD JAMES BOBACK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MS
Contact information
Practice address
40307 MIKLICH DR, MURRIETA, CA 92563-4352
(570) 362-3771
Mailing address
2828 WEEPING WILLOW RD, CHULA VISTA, CA 91915-1681
(570) 362-3771
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
34613
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS101535
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DDS101535
—
CA
Enumeration date
07/25/2017
Last updated
01/11/2023
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