Healthcare Provider Details

I. General information

NPI: 1417008228
Provider Name (Legal Business Name): CUTLER BAY DENTAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20335 OLD CUTLER RD SUITE 200
MIAMI FL
33189
US

IV. Provider business mailing address

PO BOX 106028
ATLANTA GA
30348
US

V. Phone/Fax

Practice location:
  • Phone: 305-238-6777
  • Fax: 305-253-4055
Mailing address:
  • Phone: 678-879-1177
  • Fax: 678-879-1277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS GREGG SPELIOS
Title or Position: CEO
Credential: DMD
Phone: 678-879-1177