Provider Demographics
NPI:1831258672
Name:KUJAWSKI, THOMAS G (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:KUJAWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 OBERLIN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1703
Mailing Address - Country:US
Mailing Address - Phone:858-546-0500
Mailing Address - Fax:858-546-1907
Practice Address - Street 1:5425 OBERLIN DR STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1703
Practice Address - Country:US
Practice Address - Phone:858-546-0500
Practice Address - Fax:858-546-1907
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice