Organization · Type 2 NPI

Brenda Licon

Oral and Maxillofacial Surgery (Dentist) · Tijuana, MX

NPI number 1386913838 Active

Practice location

9360-204 I Comonfort Ave
Tijuana, MX 22000

Call (664) 684-7285 Map

Mailing address

PO Box 210116
Chula Vista, CA 91921-0116

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X3212388 (ZZ)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1386913838

Brenda Licon's National Provider Identifier is 1386913838, issued on Dec 28, 2011. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Tijuana, MX. The record was last updated on Dec 28, 2011.