# KYLE FUKANO DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KYLE FUKANO DDS PLLC
- **Other names:** Forks Family Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508230038
- **Legal business name:** KYLE FUKANO DDS PLLC
- **Authorized official:** KYLE TIMOTHY FUKANO DDS (OWNER/PROVIDER)
- **Authorized official phone:** (360) 374-2288

## Contact information

- **Practice address:** 421 G ST, FORKS, WA 98331-9025
- **Practice address phone:** (360) 374-2288
- **Practice address fax:** (360) 374-2283
- **Mailing address:** PO BOX 1429, FORKS, WA 98331-1429
- **Mailing address phone:** (360) 374-2288
- **Mailing address fax:** (360) 374-2283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00008801 | WA | Yes |

## Other

- **Enumeration date:** 11/20/2015
- **Last updated:** 01/26/2016