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NPI Code Detail

MEDICARE: ANNA KIRAKOZOVA DDS

MEDICARE:   ANNA  KIRAKOZOVA  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry7999NC

General Provider Information

NPI Number : 1033247572
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA KIRAKOZOVA DDS
Provider Business Mailing Address
First Line : 1225 HOLLY HILL DR
Second Line :
City : DURHAM
State : NC
Zip : 27713-6058
Country : US
Telephone Number : 919-605-1025
Fax Number :
Provider Business Practice Location Address
First Line : 1225 HOLLY HILL DR
Second Line :
City : DURHAM
State : NC
Zip : 27713-6058
Country : US
Telephone Number : 919-605-1025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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Directions to “ ANNA KIRAKOZOVA DDS” Practice Location

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