Provider Demographics
NPI:1679727168
Name:MARRAN, KIMBERLY AC (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:AC
Last Name:MARRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 ZOE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4131
Mailing Address - Country:US
Mailing Address - Phone:323-582-2700
Mailing Address - Fax:
Practice Address - Street 1:2120 FARRELL AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-1819
Practice Address - Country:US
Practice Address - Phone:949-275-2755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist