Boback, Bernard James

Boback, Bernard James is an individual health care provider with primary practice located at 40307 Miklich Dr , Murrieta CA 92563-4352. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Boback, Bernard James can be contacted via phone (570) 362-3771.

Contact Information

Primary practice address
40307 Miklich Dr Murrieta CA 92563-4352
Phone: (570) 362-3771
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 34613 Texas
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DDS101535 California

Profile Details

NPI number 1154844702
LBN Legal business name Boback, Bernard James
Credentials DMD MS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2017
Last updated Jan 11th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154844702 NPPES
California MEDICAID DDS101535

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