Provider Demographics
NPI:1841085453
Name:JACK CUTRER, DMD, LLC
Entity type:Organization
Organization Name:JACK CUTRER, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTRER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-979-8070
Mailing Address - Street 1:2470 ROCKY RIDGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2861
Mailing Address - Country:US
Mailing Address - Phone:205-979-8070
Mailing Address - Fax:
Practice Address - Street 1:2470 ROCKY RIDGE RD STE 201
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2861
Practice Address - Country:US
Practice Address - Phone:205-979-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental