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Individual

DR. STEPHEN S KALLAOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
24099 POSTAL AVE, SUITE 102, MORENO VALLEY, CA 92553-7709
(951) 601-1385
(951) 601-1292
Mailing address
29 OROVILLE, IRVINE, CA 92602-0923
(714) 317-9821
(951) 601-1385

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
44903
CA

Other

Enumeration date
11/06/2006
Last updated
07/08/2007
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