MEDICARE: CUTBIRTH AND SANDERSON, L.L.P.

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	1223G0001X	General Practice Dentistry	16417	TX

General Provider Information

NPI Number	:	1861610297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUTBIRTH AND SANDERSON, L.L.P.

Provider Business Mailing Address
First Line	:	827 MAGNOLIA BLVD
Second Line	:	SUITE 1
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8602
Country	:	US
Telephone Number	:	281-356-3721
Fax Number	:	281-356-3778

Provider Business Practice Location Address
First Line	:	827 MAGNOLIA BLVD
Second Line	:	SUITE 1
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8602
Country	:	US
Telephone Number	:	281-356-3721
Fax Number	:	281-356-3778

Authorized Official
Title or Position	:	DR. PRESTON CUTBIRTH
Name	:	DR. PRESTON EARL CUTBIRTH
Credential	:	D.D.S.
Telephone Number	:	281-356-3721

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	06/10/2008

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