BRENDA LICON

TIJUANA, BC
NPI1386913838
Entity TypeOrganization
Authorized ContactALEJANDRO RAMOS
Biller
619-992-6290
Organization Subpart ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: ZZ  3212388)
Enumeration Date2011-12-28
Last Update Date2011-12-28
Business Address
BRENDA LICON
9360-204 I COMONFORT AVE
TIJUANA, BC 22000
Phone number: 664-684-7285
Mailing Address
BRENDA LICON
PO BOX 210116
CHULA VISTA, CA 91921-0116
Phone number: