Healthcare Provider Details

I. General information

NPI: 1770306300
Provider Name (Legal Business Name): GARRETT SCOTT KUHN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 BRONZE STAR DR STE 100
WOODLAND CA
95776-5428
US

IV. Provider business mailing address

17899 COUNTY ROAD 97
WOODLAND CA
95695-9376
US

V. Phone/Fax

Practice location:
  • Phone: 530-662-7592
  • Fax:
Mailing address:
  • Phone: 530-908-9987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number110891
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: