Provider Demographics
NPI:1861828279
Name:TOBAR, ARA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ARA
Middle Name:
Last Name:TOBAR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 575
Mailing Address - Street 2:595 CEDAR LN
Mailing Address - City:TWIN PEAKS
Mailing Address - State:CA
Mailing Address - Zip Code:92391-0575
Mailing Address - Country:US
Mailing Address - Phone:626-485-4641
Mailing Address - Fax:
Practice Address - Street 1:29101 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352-9706
Practice Address - Country:US
Practice Address - Phone:909-336-9715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23818124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist