Provider Demographics
NPI:1780687343
Name:SECCOMBE, DAVID G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:SECCOMBE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N INDIAN HILL BLVD STE C1-205
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4667
Mailing Address - Country:US
Mailing Address - Phone:909-626-5662
Mailing Address - Fax:888-506-7875
Practice Address - Street 1:101 N INDIAN HILL BLVD STE C1-205
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4667
Practice Address - Country:US
Practice Address - Phone:909-347-5362
Practice Address - Fax:888-506-7875
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice