Individual
KACIE MARIE CULOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
11671 JOLLYVILLE RD STE 204, AUSTIN, TX 78759-4141
(512) 345-9973
Mailing address
11671 JOLLYVILLE RD STE 204, AUSTIN, TX 78759-4141
(512) 345-9973
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29962
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29962
TEXAS STATE DENTAL LICENSE NUMBER
TX
Enumeration date
06/03/2014
Last updated
05/22/2024
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