Provider Demographics
NPI:1134374895
Name:KAIN II DDS INC
Entity type:Organization
Organization Name:KAIN II DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:II
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-937-9017
Mailing Address - Street 1:1111 CIVIC DR
Mailing Address - Street 2:SUITE #145
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3895
Mailing Address - Country:US
Mailing Address - Phone:925-937-9017
Mailing Address - Fax:925-937-9018
Practice Address - Street 1:1111 CIVIC DR
Practice Address - Street 2:SUITE #145
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3895
Practice Address - Country:US
Practice Address - Phone:925-937-9017
Practice Address - Fax:925-937-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-22
Last Update Date:2008-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization