Provider Demographics
NPI:1487146189
Name:KUTINA, ANDREW REPLOGLE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:REPLOGLE
Last Name:KUTINA
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 1:230 HUNTER PL APT 207
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-8027
Mailing Address - Country:US
Mailing Address - Phone:620-617-7369
Mailing Address - Fax:
Practice Address - Street 1:1640 CHARLES PL STE 101
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2868
Practice Address - Country:US
Practice Address - Phone:785-537-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS613591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty