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General NPI Number Information
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NPI Number | 1508048224
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Entity Type | Organization
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Legal Business Name | KIRKLAND DDS INC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 24301 SOUTHLAND DR STE 409F
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City | HAYWARD
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State | CA
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Zip | 94545-1551
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Country | US
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Telephone | 800-719-6107
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Fax |
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Provider Business Mailing Address
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Address Line | 26250 INDUSTRIAL BLVD STE 24
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City | HAYWARD
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State | CA
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Zip | 94545-2922
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Country | US
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Telephone | 800-719-6107
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Fax |
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | ZOYA KOGAN
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Credential | RDHAP
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Telephone | 800-719-6107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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