Individual
DR. REBECCA JOHNSON KUCERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3783
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3783
STATE OF WV DENTAL LICENS
WV
05
—
3810006780
—
WV
01
—
800340665
TAX ID
—
Enumeration date
07/19/2007
Last updated
09/21/2011
Update your record
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