Provider Demographics
NPI:1801893615
Name:CUTRELL, KEVIN K (DMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:K
Last Name:CUTRELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 409
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-9730
Mailing Address - Country:US
Mailing Address - Phone:724-423-7000
Mailing Address - Fax:724-423-7001
Practice Address - Street 1:RR 1 BOX 409
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-9730
Practice Address - Country:US
Practice Address - Phone:724-423-7000
Practice Address - Fax:724-423-7001
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021909-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice