Provider Demographics
NPI:1821209297
Name:PIKULA, AGATA AGNIESZKA (DDS)
Entity Type:Individual
Prefix:MS
First Name:AGATA
Middle Name:AGNIESZKA
Last Name:PIKULA
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 1:1420 3RD ST SE # 104
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3730
Mailing Address - Country:US
Mailing Address - Phone:313-942-5723
Mailing Address - Fax:253-697-0201
Practice Address - Street 1:1420 3RD ST SE # 104
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3730
Practice Address - Country:US
Practice Address - Phone:313-942-5723
Practice Address - Fax:253-697-0201
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605911981223P0221X
VA0401411787122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry