Provider Demographics
NPI:1316397060
Name:KURODA, DARLENE E
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:E
Last Name:KURODA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8476 SIMONDS STREET
Mailing Address - Street 2:STE 5700
Mailing Address - City:FORT GEORGE G MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755
Mailing Address - Country:US
Mailing Address - Phone:301-677-6122
Mailing Address - Fax:301-677-5710
Practice Address - Street 1:8476 SIMONDS STREET
Practice Address - Street 2:STE 5700
Practice Address - City:FORT GEORGE G MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755
Practice Address - Country:US
Practice Address - Phone:301-677-6122
Practice Address - Fax:301-677-5710
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant