Provider Demographics
NPI:1962554956
Name:KLOUTSE, AKUVI MAMU (DMD)
Entity type:Individual
Prefix:DR
First Name:AKUVI
Middle Name:MAMU
Last Name:KLOUTSE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:AKUVI
Other - Middle Name:MAMU
Other - Last Name:NZAMBI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:702 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15211-2253
Mailing Address - Country:US
Mailing Address - Phone:412-726-3797
Mailing Address - Fax:412-481-1644
Practice Address - Street 1:546 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-2463
Practice Address - Country:US
Practice Address - Phone:724-266-2099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0364321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice