Organization
TA GEREB ORTHODONTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD A GEREB D.D.S. (DOCTOR)
(619) 698-5121
Entity
Organization
Contact information
Practice address
5121 GARFIELD ST, LA MESA, CA 91941-5103
(619) 698-5121
(619) 698-1229
Mailing address
5121 GARFIELD ST, LA MESA, CA 91941-5103
(619) 698-5121
(619) 698-1229
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
40153
CA
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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