Organization
KENT NUTTALL DMD PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA COLLECCHI (OFFICE MANAGER)
(253) 939-0700
Entity
Organization
Contact information
Practice address
722 12TH ST SE, AUBURN, WA 98002-6708
(253) 939-0700
Mailing address
722 12TH ST SE, AUBURN, WA 98002-6708
(253) 939-0700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7439
WA
1223P0221X
Pediatric Dentistry
10882
WA
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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