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General NPI Number Information
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NPI Number | 1700935475
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Entity Type | Individual
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Provider Name | KRYSTYNA ANNA BARTKOWSKI I DDS
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1107 N SAN FERNANDO BLVD
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City | BURBANK
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State | CA
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Zip | 91504-4331
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Country | US
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Telephone | 818-295-2566
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Fax | 818-295-2581
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Provider Business Mailing Address
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Address Line | 2923 PARAISO WAY
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City | LA CRESCENTA
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State | CA
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Zip | 91214-2021
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Country | US
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Telephone | 818-248-3713
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Fax | 818-248-0373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 38033
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License Number State | CA
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