Individual
AE RAN KU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1096 SOUTH DORA STREET, UKIAH, CA 95482
(707) 462-5706
Mailing address
1096 S DORA ST, UKIAH, CA 95482-5737
(707) 462-5706
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
63936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63936
DENTIST
CA
Enumeration date
08/19/2014
Last updated
09/21/2016
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