Provider Demographics
NPI:1205232899
Name:KITTS, ERIC (DDS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:KITTS
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 1:201 5TH AVE S STE 103
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3646
Mailing Address - Country:US
Mailing Address - Phone:425-563-6360
Mailing Address - Fax:425-563-6366
Practice Address - Street 1:201 5TH AVE S STE 103
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3646
Practice Address - Country:US
Practice Address - Phone:425-563-6360
Practice Address - Fax:425-563-6366
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA85061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice