Healthcare Provider Details

I. General information

NPI: 1740330422
Provider Name (Legal Business Name): KIMBERLENE ESCALERA CUTTLER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4656 E MICHIGAN STREET
ORLANDO FL
32812
US

IV. Provider business mailing address

4656 E MICHIGAN STREET
ORLANDO FL
32812
US

V. Phone/Fax

Practice location:
  • Phone: 407-282-2313
  • Fax: 407-282-4948
Mailing address:
  • Phone: 407-282-2313
  • Fax: 407-282-4948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN0013658
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: