Provider Demographics
NPI:1013641943
Name:CALA, JEAN KATHLEEN BERNARDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN KATHLEEN
Middle Name:BERNARDO
Last Name:CALA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4903 82ND ST.
Mailing Address - Street 2:SUITE 20
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-798-2996
Mailing Address - Fax:806-798-2998
Practice Address - Street 1:4903 82ND ST.
Practice Address - Street 2:SUITE 20
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-798-2996
Practice Address - Fax:806-798-2998
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist