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General NPI Number Information
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NPI Number | 1639573199
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Entity Type | Organization
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Legal Business Name | 2K FULLERTON DENTAL
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 1010 E CHAPMAN AVE
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City | FULLERTON
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State | CA
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Zip | 92831-3812
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Country | US
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Telephone | 714-526-2828
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Fax | 714-526-2834
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Provider Business Mailing Address
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Address Line | 1010 E CHAPMAN AVE
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City | FULLERTON
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State | CA
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Zip | 92831-3812
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Country | US
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Telephone | 714-526-2828
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Fax | 714-526-2834
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Authorized Official
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Title or Position | OWNER
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Name | DR. KUSH PATEL
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Credential | DDS
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Telephone | 714-526-2828
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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 | 59613
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License Number State | CA
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