Provider Demographics
NPI:1649890583
Name:MCNUTT, DAVID EUGENE (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EUGENE
Last Name:MCNUTT
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 1:813 CHALKSTONE LN
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-0628
Mailing Address - Country:US
Mailing Address - Phone:615-739-4703
Mailing Address - Fax:
Practice Address - Street 1:3817 BEDFORD AVE STE 120
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2534
Practice Address - Country:US
Practice Address - Phone:615-383-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN114251223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry