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Individual

KIEN CHIBAYERE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
60 MDG/SGDR, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1906
(707) 423-7085
Mailing address
60 MDG/SGDR, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1906

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
057159
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
111520
CA

Other

Enumeration date
08/29/2012
Last updated
06/16/2025
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