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General NPI Number Information
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NPI Number | 1285457721
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Entity Type | Organization
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Legal Business Name | YAN KALIKA DENTAL CORPORATION
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 172 E D ST
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City | BENICIA
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State | CA
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Zip | 94510-3223
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Country | US
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Telephone | 916-259-9255
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Fax |
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Provider Business Mailing Address
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Address Line | 3075 BEACON BLVD
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-3462
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. YAN KALIKA
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Credential | DMD
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Telephone | 916-297-6603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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