Provider Demographics
NPI:1467676593
Name:CUTBIRTH, STEVEN TIPPEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:TIPPEN
Last Name:CUTBIRTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 LAKE SUCCESS DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-2908
Mailing Address - Country:US
Mailing Address - Phone:254-772-5420
Mailing Address - Fax:254-772-6540
Practice Address - Street 1:1613 LAKE SUCCESS DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2908
Practice Address - Country:US
Practice Address - Phone:254-772-5420
Practice Address - Fax:254-772-6540
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice