Provider Demographics
NPI:1528589264
Name:KUTKAT, MOLLY CHRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:CHRISTINE
Last Name:KUTKAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6119
Mailing Address - Country:US
Mailing Address - Phone:605-679-7227
Mailing Address - Fax:
Practice Address - Street 1:2400 W 41ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6119
Practice Address - Country:US
Practice Address - Phone:605-679-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD11691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice