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General NPI Number Information
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NPI Number | 1184817405
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL DUTNER D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 9900 LINCOLN STREET
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-4079
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 LINCOLN STREET
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City | TACOMA
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State | WA
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Zip | 98431-1100
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Country | US
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Telephone | 253-968-4079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6058-015
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 6058-015
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License Number State | WI
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