Provider Demographics
NPI:1447690060
Name:PATRICIA Y VANKOOTEN DMD INC
Entity type:Organization
Organization Name:PATRICIA Y VANKOOTEN DMD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:VAN KOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:831-373-0478
Mailing Address - Street 1:251 LIGHTHOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1416
Mailing Address - Country:US
Mailing Address - Phone:831-373-0478
Mailing Address - Fax:831-373-0137
Practice Address - Street 1:251 LIGHTHOUSE AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-1416
Practice Address - Country:US
Practice Address - Phone:831-373-0478
Practice Address - Fax:831-373-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty