Provider Demographics
NPI:1235283797
Name:KNUUT, ANNE-LI (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNE-LI
Middle Name:
Last Name:KNUUT
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 1:190 SAN MARIN DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-1218
Mailing Address - Country:US
Mailing Address - Phone:415-898-7093
Mailing Address - Fax:
Practice Address - Street 1:190 SAN MARIN DR
Practice Address - Street 2:SUITE C
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-1218
Practice Address - Country:US
Practice Address - Phone:415-898-7093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADT337891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics