Healthcare Provider Details

I. General information

NPI: 1164937140
Provider Name (Legal Business Name): ARJUN KAUL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 09/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 E KINGS CANYON RD
FRESNO CA
93727
US

IV. Provider business mailing address

530 S MAIN ST
ORANGE CA
92868-4525
US

V. Phone/Fax

Practice location:
  • Phone: 559-490-1343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number102241
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: