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Individual

DR. JAIME NMN BULKACZ

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS PHD

Contact information

Practice address
18740 VENTURA BLVD, SUITE 306, TARZANA, CA 91356
(818) 609-8655
(818) 609-8644
Mailing address
18740 VENTURA BLVD, SUITE 306, TARZANA, CA 91356
(818) 609-8655
(818) 609-8644

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
32278
CA

Other

Enumeration date
02/28/2006
Last updated
07/08/2007
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