BRENDA LICON
Organization (NPI-2)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1386913838- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 9360-204 I COMONFORT AVE, TIJUANA, BC, 22000
- Phone
- (664) 684-7285
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
Primary License: ZZ #3212388
All Addresses
MAILING
PO BOX 210116
CHULA VISTA, CA, 919210116