Provider Demographics
NPI:1346391133
Name:MATTHEWS, JENNIFER CUTLER (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CUTLER
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11217 PRESIDIO DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8552
Mailing Address - Country:US
Mailing Address - Phone:919-425-0793
Mailing Address - Fax:
Practice Address - Street 1:10411 MONCREIFFE RD STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7820
Practice Address - Country:US
Practice Address - Phone:919-405-7075
Practice Address - Fax:919-405-1302
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice