Provider Demographics
NPI:1598319444
Name:MANEEZA KULALY, DMD, PC
Entity Type:Organization
Organization Name:MANEEZA KULALY, DMD, PC
Other - Org Name:HARBOR DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANEEZA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KULALY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:925-526-0000
Mailing Address - Street 1:2931 HARBOR ST STE I
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5464
Mailing Address - Country:US
Mailing Address - Phone:214-516-5000
Mailing Address - Fax:
Practice Address - Street 1:2931 HARBOR ST STE I
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5464
Practice Address - Country:US
Practice Address - Phone:925-526-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty