Provider Demographics
NPI:1528726031
Name:JI AE CUTTER DMD PROFESSIONAL CORP
Entity type:Organization
Organization Name:JI AE CUTTER DMD PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JI AE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-220-8488
Mailing Address - Street 1:6376 SPRING MOUNTAIN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8818
Mailing Address - Country:US
Mailing Address - Phone:702-220-8488
Mailing Address - Fax:
Practice Address - Street 1:6376 SPRING MOUNTAIN RD STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8818
Practice Address - Country:US
Practice Address - Phone:702-220-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty