Provider Demographics
NPI:1912342940
Name:KILKER, TERENCE ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:ALAN
Last Name:KILKER
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 1:17300 YORBA LINDA BLVD
Mailing Address - Street 2:STE. B
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3810
Mailing Address - Country:US
Mailing Address - Phone:714-996-2255
Mailing Address - Fax:714-996-3674
Practice Address - Street 1:17300 YORBA LINDA BLVD
Practice Address - Street 2:STE. B
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3810
Practice Address - Country:US
Practice Address - Phone:714-996-2255
Practice Address - Fax:714-996-3674
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist