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Individual

DR. CARLOS ENRIQUE SIBAJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
895 E VISTA WAY # C, VISTA, CA 92084-5237
(760) 201-3414
Mailing address
895 E VISTA WAY # C, VISTA, CA 92084-5237
(760) 201-3414

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61133
CA

Other

Enumeration date
02/27/2012
Last updated
02/27/2012
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