Healthcare Provider Details
I. General information
NPI: 1093481053
Provider Name (Legal Business Name): DARYNA ALEXANDRA KUTUZA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/19/2021
Last Update Date: 02/11/2023
Certification Date: 02/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7372 MCKNIGHT RD STE B
PITTSBURGH PA
15237-3558
US
IV. Provider business mailing address
1 PIUS ST STE B4
PITTSBURGH PA
15203-1657
US
V. Phone/Fax
- Phone: 412-364-6440
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DS043381 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: