Provider Demographics
NPI:1568508331
Name:KURITANI, RONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:KURITANI
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 1:2215 N 30TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3350
Mailing Address - Country:US
Mailing Address - Phone:235-572-3082
Mailing Address - Fax:253-572-3168
Practice Address - Street 1:2215 N 30TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3350
Practice Address - Country:US
Practice Address - Phone:235-572-3082
Practice Address - Fax:253-572-3168
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000069241223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics