Provider Demographics
NPI:1972127769
Name:MCNUTT & ASSOCIATES I, DDS, P.A.
Entity type:Organization
Organization Name:MCNUTT & ASSOCIATES I, DDS, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-452-3269
Mailing Address - Street 1:303 DEVONHALL LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-2654
Mailing Address - Country:US
Mailing Address - Phone:919-452-3269
Mailing Address - Fax:
Practice Address - Street 1:305 ASHVILLE AVE STE H
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6667
Practice Address - Country:US
Practice Address - Phone:919-452-3269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty