Provider Demographics
NPI:1104839109
Name:KURIO, KEVIN M (DDS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:KURIO
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 1:4800 GRANITE DR
Mailing Address - Street 2:SUITE B-8
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2800
Mailing Address - Country:US
Mailing Address - Phone:916-632-1220
Mailing Address - Fax:
Practice Address - Street 1:4800 GRANITE DR
Practice Address - Street 2:SUITE B-8
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2800
Practice Address - Country:US
Practice Address - Phone:916-632-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31817122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist