Individual
BRUCE LEE TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25835 BARTON RD., STE 104, LOMA LINDA, CA 92354
(909) 796-2299
(909) 796-2509
Mailing address
25835 BARTON RD., STE 104, LOMA LINDA, CA 92354
(909) 796-2299
(909) 796-2509
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538368154
DENTIST
CA
Enumeration date
11/22/2013
Last updated
11/22/2013
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