Individual
DR. DAVID TABATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1413 FOOTHILL BLVD STE B, LA VERNE, CA 91750-3418
(909) 596-1831
(909) 593-4722
Mailing address
1413 FOOTHILL BLVD STE B, LA VERNE, CA 91750-3418
(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
10/29/2015
Last updated
10/29/2015
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