Organization
CHASE KOTULA DENTAL PARTNERSHIP
Active
Other names
Marin Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE MARGARET KOTULA DDS (DOCTOR)
(415) 265-4115
Entity
Organization
Contact information
Practice address
4050 REDWOOD HWY, SUITE A, SAN RAFAEL, CA 94903-5149
(415) 499-7700
Mailing address
4050 REDWOOD HWY, SUITE A, SAN RAFAEL, CA 94903-5149
(415) 499-7700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
37319
CA
1223G0001X
General Practice Dentistry
59323
CA
Other
Enumeration date
01/25/2013
Last updated
01/25/2013
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