Provider Demographics
NPI:1831279736
Name:RICHARD J. KRATOCHVIL D.D.S., INC.
Entity Type:Organization
Organization Name:RICHARD J. KRATOCHVIL D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KRATOCHVIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-787-6060
Mailing Address - Street 1:7136 HASKELL AVE
Mailing Address - Street 2:SUITE #217
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4112
Mailing Address - Country:US
Mailing Address - Phone:818-787-6060
Mailing Address - Fax:
Practice Address - Street 1:7136 HASKELL AVE
Practice Address - Street 2:SUITE #217
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4112
Practice Address - Country:US
Practice Address - Phone:818-787-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty