Provider Demographics
NPI:1356568091
Name:DUHAYLUNGSOD, BABY MARIFLOR SABALBURO (DMD)
Entity type:Individual
Prefix:
First Name:BABY MARIFLOR
Middle Name:SABALBURO
Last Name:DUHAYLUNGSOD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARIFLOR
Other - Middle Name:
Other - Last Name:DUHAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD INC
Mailing Address - Street 1:340 FOURTH AVE.
Mailing Address - Street 2:SUITE 15
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910
Mailing Address - Country:US
Mailing Address - Phone:619-422-6121
Mailing Address - Fax:619-422-8082
Practice Address - Street 1:340 4TH AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3813
Practice Address - Country:US
Practice Address - Phone:619-422-6121
Practice Address - Fax:619-422-8082
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice