Provider Demographics
NPI:1265651426
Name:KILKUTS, ARTHUR WALTER (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:WALTER
Last Name:KILKUTS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 WASHBURN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-4362
Mailing Address - Country:US
Mailing Address - Phone:951-736-8133
Mailing Address - Fax:951-736-1425
Practice Address - Street 1:914 WASHBURN AVE STE 3
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4362
Practice Address - Country:US
Practice Address - Phone:951-736-8133
Practice Address - Fax:951-736-1425
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0321041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery