Provider Demographics
NPI:1831903012
Name:LISBETH ROBLES
Entity type:Organization
Organization Name:LISBETH ROBLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-349-6409
Mailing Address - Street 1:644 E SAN YSIDRO BLVD. STE G-752
Mailing Address - Street 2:
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173
Mailing Address - Country:US
Mailing Address - Phone:619-349-6409
Mailing Address - Fax:619-354-2449
Practice Address - Street 1:JOSE MARIA LARROQUE #375-2
Practice Address - Street 2:COL. FEDERAL
Practice Address - City:TIJUANA
Practice Address - State:BC
Practice Address - Zip Code:22010
Practice Address - Country:MX
Practice Address - Phone:619-349-6409
Practice Address - Fax:619-354-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty