Organization
MK RAYMOND DENTAL CORPORATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M. KYLE RAYMOND (D.D.S./OWNER)
(661) 872-2170
Entity
Organization
Contact information
Practice address
3130 UNION AVE, BAKERSFIELD, CA 93305-3443
(661) 872-2170
(818) 773-0911
Mailing address
3130 UNION AVE, BAKERSFIELD, CA 93305-3443
(661) 872-2170
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105526
CA DENTAL LICENSE
CA
Enumeration date
11/18/2020
Last updated
03/04/2021
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