Individual
MATTHEW NUTTALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 N PEARL ST, TACOMA, WA 98406-2540
(253) 752-6349
Mailing address
5908 63RD AVENUE CT NW, GIG HARBOR, WA 98335-7388
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60750254
WA
Other
Enumeration date
06/03/2017
Last updated
06/03/2017
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