Provider Demographics
NPI:1538271309
Name:KUTCIPAL, ELIZABETH A (DDS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:KUTCIPAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 NW MARKET STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107
Mailing Address - Country:US
Mailing Address - Phone:206-427-6325
Mailing Address - Fax:206-784-4812
Practice Address - Street 1:1448 NW MARKET STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107
Practice Address - Country:US
Practice Address - Phone:206-427-6325
Practice Address - Fax:206-784-4812
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADR200001141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery