MEDICARE: DAVID KUTNER DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	27016	CA

General Provider Information

NPI Number	:	1346303492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KUTNER DMD

Provider Business Mailing Address
First Line	:	3701 SANTA ANIND AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732
Country	:	US
Telephone Number	:	626-442-4582
Fax Number	:	626-443-1212

Provider Business Practice Location Address
First Line	:	3701 SANTA ANIND AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732
Country	:	US
Telephone Number	:	626-442-4582
Fax Number	:	626-443-1212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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