Individual
DR. STACEY R KUTSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
7501 W DESCHUTES PL, KENNEWICK, WA 99336-7719
(509) 783-1960
(509) 783-7576
Mailing address
7501 W DESCHUTES PL, KENNEWICK, WA 99336-7719
(509) 783-1960
(509) 783-7576
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00010428
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036876
—
WA
05
—
5050265
—
WA
01
—
CS10000430
CONSCIOUS SEDATION
WA
Enumeration date
10/11/2006
Last updated
03/07/2023
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