Provider Demographics
NPI:1275693368
Name:KAUTZMAN, GAIL HELEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:HELEN
Last Name:KAUTZMAN
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 1:13410 HWY 99 SOUTH
Mailing Address - Street 2:SUITE 104
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204
Mailing Address - Country:US
Mailing Address - Phone:425-742-0840
Mailing Address - Fax:425-742-0840
Practice Address - Street 1:13410 HWY 99 SOUTH
Practice Address - Street 2:SUITE 104
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204
Practice Address - Country:US
Practice Address - Phone:425-742-0840
Practice Address - Fax:425-742-0840
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice