Healthcare Provider Details

I. General information

NPI: 1750135752
Provider Name (Legal Business Name): C. KULYK DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 D ST STE A
RAMONA CA
92065-3937
US

IV. Provider business mailing address

10903 CAMINITO CUESTA
SAN DIEGO CA
92131-3572
US

V. Phone/Fax

Practice location:
  • Phone: 760-654-3070
  • Fax:
Mailing address:
  • Phone: 925-457-8316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA KULYK ARRIETA
Title or Position: OWNER
Credential: DDS
Phone: 925-457-8316