| Carmel Mountain Oral & Facial Surgery | |
|
9912 Carmel Mountain Rd Ste A San Diego CA 92129-2808 | |
| (858) 484-6418 | |
| (858) 484-6318 |
| Full Name | Carmel Mountain Oral & Facial Surgery |
|---|---|
| Speciality | Specialist |
| Location | 9912 Carmel Mountain Rd Ste A, San Diego, California |
| Authorized Official Name and Position | Kierian Brian Kuklok (OWNER) |
| Authorized Official Contact | 8584846418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carmel Mountain Oral & Facial Surgery 9912 Carmel Mountain Rd Ste A San Diego CA 92129-2808 Ph: (858) 484-6418 | Carmel Mountain Oral & Facial Surgery 9912 Carmel Mountain Rd Ste A San Diego CA 92129-2808 Ph: (858) 484-6418 |
| NPI Number | 1174739700 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174739700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | OMS29 (California) | Primary |
| 174400000X | Specialist | A68737 (California) | Primary |
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