Provider Demographics
NPI:1649207788
Name:KESTLER, VICKI VIDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:VIDA
Last Name:KESTLER
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 1:1008 W. AVE M-14 SUITE B
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551
Mailing Address - Country:US
Mailing Address - Phone:661-947-7777
Mailing Address - Fax:661-947-7797
Practice Address - Street 1:1008 W AVENUE M14
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1441
Practice Address - Country:US
Practice Address - Phone:661-947-7777
Practice Address - Fax:661-947-7797
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA418421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice