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General NPI Number Information
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NPI Number | 1902334238
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Entity Type | Individual
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Provider Name | CHRISTINE DEBAZ DMD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 307 N BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-4053
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Country | US
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Telephone | 714-594-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 740 S CARRIAGE CIR
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City | ANAHEIM
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State | CA
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Zip | 92807-4905
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Country | US
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Telephone | 440-488-5390
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 003858
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 104941
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.025307
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License Number State | OH
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