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General NPI Number Information
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NPI Number | 1891979191
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Entity Type | Organization
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Legal Business Name | TABERNA DENTAL CORPORATION
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 282 S MAIN ST
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City | MILPITAS
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State | CA
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Zip | 95035-5315
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Country | US
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Telephone | 408-946-4815
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Fax | 408-946-3249
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Provider Business Mailing Address
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Address Line | 282 S. MAIN ST.
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City | MILPITAS
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State | CA
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Zip | 95035-5315
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Country | US
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Telephone | 408-946-4815
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Fax | 408-946-3249
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MILAGROS LINGAT TABERNA
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Credential | D.M.D.
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Telephone | 408-946-4815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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