Individual
AMANDA LUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3110 KERNER BLVD, SAN RAFAEL, CA 94901-5411
(415) 448-1500
Mailing address
3110 KERNER BLVD, SAN RAFAEL, CA 94901-5411
(415) 448-1500
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
33031
CA
Other
Enumeration date
12/21/2020
Last updated
02/14/2021
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