Individual
BRENDA LOUISE KUECKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
16455 MAIN ST, #17, HESPERIA, CA 92345-3554
(760) 244-6077
Mailing address
1042 N MOUNTAIN AVE, SUITE B-111, UPLAND, CA 91786-3695
(951) 870-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
47428
CA
Other
Enumeration date
10/06/2006
Last updated
10/15/2013
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