Provider Demographics
NPI:1063641256
Name:DEVIAN, GARY L (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:DEVIAN
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:17300 YORBA LINDA BLVD
Mailing Address - Street 2:SUITE K
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3810
Mailing Address - Country:US
Mailing Address - Phone:714-524-6111
Mailing Address - Fax:714-985-0256
Practice Address - Street 1:17300 YORBA LINDA BLVD
Practice Address - Street 2:SUITE K
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3810
Practice Address - Country:US
Practice Address - Phone:714-524-6111
Practice Address - Fax:714-985-0256
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA306201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics