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General NPI Number Information
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NPI Number | 1992358964
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Entity Type | Individual
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Provider Name | ROBLEN GUEVARRA NIEBLAS DDS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 3554 W MT WHITNEY
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City | RIVERDALE
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State | CA
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Zip | 93656
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Country | US
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Telephone | 559-867-4000
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Fax | 559-867-1100
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Provider Business Mailing Address
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Address Line | PO BOX 580
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City | LEMOORE
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State | CA
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Zip | 93245-0580
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Country | US
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Telephone | 559-386-4500
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Fax | 559-386-5080
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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 | 104058
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License Number State | CA
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