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General NPI Number Information
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NPI Number | 1437598216
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Entity Type | Individual
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Provider Name | CODY CUTLER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 23844 S POWER RD STE. B106
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6152
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Country | US
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Telephone | 317-753-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 23424 S 223RD PL
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3218
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Country | US
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Telephone | 317-753-1570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12011994A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8928
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License Number State | AZ
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