Provider Demographics
NPI:1235295080
Name:MUTTI, JAMES H (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:MUTTI
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:11940 QUIVIRA RD.
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213
Mailing Address - Country:US
Mailing Address - Phone:913-469-9191
Mailing Address - Fax:913-451-2251
Practice Address - Street 1:2109 NE 72ND ST
Practice Address - Street 2:STE. 103
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118
Practice Address - Country:US
Practice Address - Phone:913-469-9191
Practice Address - Fax:913-451-2251
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2013-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOMO0108601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics