Provider Demographics
NPI:1427160530
Name:KALWARA, KRISTIN C (DDS)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:C
Last Name:KALWARA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 N HIGHWAY 27
Mailing Address - Street 2:SUITE F
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2448
Mailing Address - Country:US
Mailing Address - Phone:352-243-0018
Mailing Address - Fax:352-243-6700
Practice Address - Street 1:194 N HIGHWAY 27
Practice Address - Street 2:SUITE F
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2448
Practice Address - Country:US
Practice Address - Phone:352-243-0018
Practice Address - Fax:352-243-6700
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00087681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice