Provider Demographics
NPI:1992269179
Name:CUTLER DENTAL CARE, PLLC
Entity type:Organization
Organization Name:CUTLER DENTAL CARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:C
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-830-0175
Mailing Address - Street 1:SHADOW MOUNTAIN DENTAL GROUP
Mailing Address - Street 2:6525 N. DECATUR BLVD. STE. 150
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131
Mailing Address - Country:US
Mailing Address - Phone:702-577-1941
Mailing Address - Fax:702-395-7813
Practice Address - Street 1:9690 W TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-2601
Practice Address - Country:US
Practice Address - Phone:928-277-6575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty