| NPI | 1053875096 |
|---|---|
| Former Legal Business Name | JOHN K TIDWELL DDS AND ELIZABETH A KUTCIPAL DDS PLLC |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH A KUTCIPAL Owner 206-783-9672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2022-09-09 |