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NPI Code Detail

MEDICARE: DR. KUNJAN KAKAR DDS

MEDICARE: DR. KUNJAN KAKAR DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist10361CO

General Provider Information

NPI Number : 1922304237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KUNJAN KAKAR DDS
Provider Business Mailing Address
First Line : 201 W 8TH ST
Second Line : SUITE 810
City : PUEBLO
State : CO
Zip : 81003-3038
Country : US
Telephone Number : 719-562-4447
Fax Number :
Provider Business Practice Location Address
First Line : 1022 LIBERTY LN
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2039
Country : US
Telephone Number : 719-545-5778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2011
Last Update Date : 02/23/2011

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