Provider Demographics
NPI:1225162233
Name:KURATOMI, REED KEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:REED
Middle Name:KEN
Last Name:KURATOMI
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 1:3121 PARK AVE STE G
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2956
Mailing Address - Country:US
Mailing Address - Phone:831-475-0656
Mailing Address - Fax:831-464-3272
Practice Address - Street 1:3121 PARK AVE STE G
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2956
Practice Address - Country:US
Practice Address - Phone:831-475-0656
Practice Address - Fax:831-464-3272
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28181CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice