Organization
KYLE FUKANO DDS PLLC
Active
Parent organization
KYLE FUKANO DDS PLLC
Other names
Forks Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
KYLE FUKANO DDS PLLC
Authorized official
KYLE TIMOTHY FUKANO DDS (OWNER/PROVIDER)
(360) 374-2288
Entity
Organization
Contact information
Practice address
421 G ST, FORKS, WA 98331-9025
(360) 374-2288
(360) 374-2283
Mailing address
PO BOX 1429, FORKS, WA 98331-1429
(360) 374-2288
(360) 374-2283
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008801
WA
Other
Enumeration date
11/20/2015
Last updated
01/26/2016
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