Provider Demographics
NPI:1417008228
Name:CUTLER BAY DENTAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:CUTLER BAY DENTAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:SPELIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-879-1177
Mailing Address - Street 1:PO BOX 106028
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30348
Mailing Address - Country:US
Mailing Address - Phone:678-879-1177
Mailing Address - Fax:678-879-1277
Practice Address - Street 1:20335 OLD CUTLER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189
Practice Address - Country:US
Practice Address - Phone:305-238-6777
Practice Address - Fax:305-253-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service