Provider Demographics
NPI:1881628923
Name:KUO, ERIC (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:KUO
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 1:2001 UNION ST STE 664
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4111
Mailing Address - Country:US
Mailing Address - Phone:415-775-5774
Mailing Address - Fax:415-921-2890
Practice Address - Street 1:2001 UNION ST STE 664
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4111
Practice Address - Country:US
Practice Address - Phone:415-775-5774
Practice Address - Fax:415-921-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics