Organization
DAVID A TABATA D D S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A TABATA DDS (OWNER)
(909) 596-1831
Entity
Organization
Contact information
Practice address
1413 FOOTHILL BLVD, STE B, LAVERNE, CA 91750
(909) 596-1833
(909) 593-4722
Mailing address
1413 FOOTHILL BLVD, LAVERNE, CA 91750
(909) 596-1831
(909) 593-4722
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
26542
CA
Other
Enumeration date
11/21/2006
Last updated
03/22/2012
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