Provider Demographics
NPI:1770676702
Name:KNUTZEN, GEORGE PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PAUL
Last Name:KNUTZEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 UNIVERSITY WAY NE
Mailing Address - Street 2:#206
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6257
Mailing Address - Country:US
Mailing Address - Phone:206-632-3000
Mailing Address - Fax:206-634-0478
Practice Address - Street 1:4115 UNIVERSITY WAY NE
Practice Address - Street 2:#206
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6257
Practice Address - Country:US
Practice Address - Phone:206-632-3000
Practice Address - Fax:206-634-0478
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist