Provider Demographics
NPI:1851693329
Name:KULYK, OLHA P
Entity Type:Individual
Prefix:MRS
First Name:OLHA
Middle Name:P
Last Name:KULYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OLHA
Other - Middle Name:P
Other - Last Name:KOPIY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1450 CREEKSIDE DR APT 61
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5535
Mailing Address - Country:US
Mailing Address - Phone:925-935-1898
Mailing Address - Fax:
Practice Address - Street 1:1450 CREEKSIDE DR APT 61
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5535
Practice Address - Country:US
Practice Address - Phone:925-935-1898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist