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Organization
JACQUELINE KOTULA, DDS, INC.
Active
Organization
JACQUELINE KOTULA, DDS, INC.
Active
Other names
Marin Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE KOTULA DDS (OWNER)
(415) 499-7700
Entity
Organization
Contact information
Practice address
4050 REDWOOD HWY STE A, SAN RAFAEL, CA 94903-5149
(415) 499-7700
Mailing address
4050 REDWOOD HWY STE A, SAN RAFAEL, CA 94903-5149
(415) 499-7700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659682888
NPI 1
CA
Enumeration date
03/02/2022
Last updated
03/02/2022
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