Organization
BUBALO DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA BUBALO DDS (OWNER DENTIST)
(408) 466-4197
Entity
Organization
Contact information
Practice address
306 WALNUT AVE STE 24, SAN DIEGO, CA 92103-4980
(619) 232-1005
Mailing address
306 WALNUT AVE STE 24, SAN DIEGO, CA 92103-4980
(619) 232-1005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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