| Chase Kotula Dental Partnership | |
|
4050 Redwood Hwy Suite A San Rafael CA 94903-5149 | |
| (415) 499-7700 | |
| Not Available |
| Full Name | Chase Kotula Dental Partnership |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4050 Redwood Hwy, San Rafael, California |
| Authorized Official Name and Position | Jacqueline Margaret Kotula (DOCTOR) |
| Authorized Official Contact | 4152654115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chase Kotula Dental Partnership 4050 Redwood Hwy Suite A San Rafael CA 94903-5149 Ph: (415) 499-7700 | Chase Kotula Dental Partnership 4050 Redwood Hwy Suite A San Rafael CA 94903-5149 Ph: (415) 499-7700 |
| NPI Number | 1154669190 |
|---|---|
| Provider Enumeration Date | 01/25/2013 |
| Last Update Date | 01/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154669190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 59323 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | 37319 (California) | Primary |
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