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NPI Code Detail

MEDICARE: DR. DAVID G. SECCOMBE DDS

MEDICARE: DR. DAVID G. SECCOMBE DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry28236CA

General Provider Information

NPI Number : 1780687343
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID G. SECCOMBE DDS
Provider Business Mailing Address
First Line : 101 N INDIAN HILL BLVD STE C1-205
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4667
Country : US
Telephone Number : 909-626-5662
Fax Number : 888-506-7875
Provider Business Practice Location Address
First Line : 101 N INDIAN HILL BLVD STE C1-205
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4667
Country : US
Telephone Number : 909-347-5362
Fax Number : 888-506-7875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 10/04/2023

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