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General NPI Number Information
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NPI Number | 1508789843
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Entity Type | Organization
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Legal Business Name | TWK DENTISTRY PC
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 14 VIA BUEN CORAZON
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-7022
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Country | US
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Telephone | 559-355-8435
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Fax |
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Provider Business Mailing Address
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Address Line | 14 VIA BUEN CORAZON
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-7022
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Country | US
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Telephone | 559-355-8435
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TYLER KISLING
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Credential | DDS
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Telephone | 559-355-8435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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