Chase Kotula Dental Partnership

NPI 1154669190 - Dentist - 1223G0001X

NPI Details
NPI 1154669190
Enumeration Date 01/25/2013
Last Updated 01/25/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name JACQUELINE MARGARET JACQUELINE
Position DOCTOR
Phone (415) 499-7700
Fax
Practice Location
4050 REDWOOD HWY
SUITE A
SAN RAFAEL CA, 94903-5149, US
Phone (415) 499-7700
Fax
Business Location
4050 REDWOOD HWY
SUITE A
SAN RAFAEL CA, 94903-5149, US
Phone (415) 499-7700
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 59323
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According to our database, Chase Kotula Dental Partnership NPI is 1154669190, taxonomy code is 1223G0001X and license number is 59323, license state is located at California. Chase Kotula Dental Partnership physically located at 4050 Redwood Hwy, San Rafael CA, 94903-5149. NPI Number 1033115704 has the healthcare provider type.

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1154669190 NPI number is provided on an as is basis without warranty of any kind. 1154669190 is maintained by the National Plan & Provider Enumeration System. The contents of Chase Kotula Dental Partnership are for informational purposes only.