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Individual

DR. GUY CARLETON LICHTY II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3030 CHILDRENS WAY, SUITE 107, SAN DIEGO, CA 92123-4232
(858) 492-9977
Mailing address
PO BOX 530869, SAN DIEGO, CA 92153-0869
(619) 421-9132

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
27644
CA

Other

Enumeration date
02/05/2007
Last updated
07/08/2007
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