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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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