Provider Demographics
NPI:1689732083
Name:JUROSKY, KATHRYN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:A
Last Name:JUROSKY
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 1:500 MIDDLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2123
Mailing Address - Country:US
Mailing Address - Phone:650-328-6356
Mailing Address - Fax:
Practice Address - Street 1:500 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2123
Practice Address - Country:US
Practice Address - Phone:650-328-6356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics