MEDICARE: DR. JEROME C CUTLER D.D.S.

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	6407	AZ
2	122300000X	Dentist	3694	NV

General Provider Information

NPI Number	:	1659435857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROME C CUTLER D.D.S.

Provider Business Mailing Address
First Line	:	9690 W TROPICANA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-2601
Country	:	US
Telephone Number	:	702-410-6633
Fax Number	:

Provider Business Practice Location Address
First Line	:	9690 W TROPICANA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-2601
Country	:	US
Telephone Number	:	702-410-6633
Fax Number	:

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	04/08/2019

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Directions to “ DR. JEROME C CUTLER D.D.S.” Practice Location

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