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Stacey Kutsch, D.d.s., M.s., Pllc
Dental Clinic/Center in Walla Walla, Washington
NPI 1629491766

Stacey Kutsch, D.d.s., M.s., Pllc is a Dental Clinic/Center based in Walla Walla, WA and is specialized in Dental. Stacey Kutsch, D.d.s., M.s., Pllc practices in Walla Walla, WA. The NPI Number for Stacey Kutsch, D.d.s., M.s., Pllc is 1629491766 and holds a License No. DE00010428 (Washington).

The current practice location address for Stacey Kutsch, D.d.s., M.s., Pllc is 614 E Alder St, Walla Walla, WA and can be reached out via phone at 509-522-0555.

Location: 614 E Alder St, Walla Walla, WA, 99362-2073
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629491766
Provider Name
Stacey Kutsch, D.d.s., M.s., Pllc
Credential
Provider Entity Type
Organization
Address
614 E Alder St, Walla Walla, WA, 99362-2073
Phone Number
509-522-0555
Fax Number
Provider Enumeration Date
01/25/2014
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CS10000430 01 WA CONSCIOUS SEDATION PERMIT
5050265 05 WA
DE00010428 01 WA DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
614 E Alder St
City
Walla Walla
State
Washington
Zip
99362-2073
Phone Number
509-522-0555
Fax Number
person
Provider Business Mailing Address Details
Address
614 E Alder St
City
Walla Walla
State
Washington
Zip
99362-2073
Phone Number
509-522-0555
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DE00010428 (Washington)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
DE00010428 (Washington)
Definition
Definition to come...
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