Kodama, Keith S

Kodama, Keith S is an sole proprietor health care provider with primary practice located at 14213 Red Hill Ave , Tustin CA 92780-5835. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Kodama, Keith S can be contacted via phone (714) 832-8220.

Contact Information

Primary practice address
14213 Red Hill Ave Tustin CA 92780-5835
Phone: (714) 832-8220
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 32646 California

Profile Details

NPI number 1164588737
LBN Legal business name Kodama, Keith S
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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