# KENT NUTTALL DMD PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942533351
- **Authorized official:** JANNA COLLECCHI (OFFICE MANAGER)
- **Authorized official phone:** (253) 939-0700

## Contact information

- **Practice address:** 722 12TH ST SE, AUBURN, WA 98002-6708
- **Practice address phone:** (253) 939-0700
- **Mailing address:** 722 12TH ST SE, AUBURN, WA 98002-6708
- **Mailing address phone:** (253) 939-0700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7439 | WA | Yes |
| 1223P0221X | Pediatric Dentistry | 10882 | WA | — |

## Other

- **Enumeration date:** 09/16/2009
- **Last updated:** 09/16/2009