Provider Demographics
NPI:1326277112
Name:CUTLER, ERIN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:C
Last Name:CUTLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-1918
Mailing Address - Country:US
Mailing Address - Phone:715-685-2200
Mailing Address - Fax:715-685-2202
Practice Address - Street 1:719 MAIN ST E
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1918
Practice Address - Country:US
Practice Address - Phone:715-685-2200
Practice Address - Fax:715-685-2202
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8754122300000X, 1223E0200X, 1223G0001X, 1223P0221X, 1223P0300X, 1223P0700X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223E0200XDental ProvidersDentistEndodontics
No1223P0221XDental ProvidersDentistPediatric Dentistry
No1223P0300XDental ProvidersDentistPeriodontics
No1223P0700XDental ProvidersDentistProsthodontics
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1326277112Medicaid