Individual
DEVON MARIE KUTANOVSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
229 S EAST ST, CROWN POINT, IN 46307-4058
(219) 356-0216
Mailing address
10010 WHITE JASMINE DR, SAINT JOHN, IN 46373-0580
(925) 596-0220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.032629
IL
1223G0001X
General Practice Dentistry
Primary
12013425A
IN
Other
Enumeration date
06/23/2020
Last updated
05/23/2024
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