| NPI | 1417967290 |
|---|---|
| Former Legal Business Name | DAVID L. TAGGE, D.D.S., M.S.D. AND BRADLEY D. BOURCY, D.D.S., M.S., IN |
| Entity Type | Organization |
| Authorized Contact | RYAN D. HARBERTSON Owner/Partner 760-741-4061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: CA 042637) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2014-01-10 |