Organization
CHARLES D MCNUTT DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DANIEL MCNUTT DDS (PRESIDENT)
(954) 741-2323
Entity
Organization
Contact information
Practice address
3501 NW 84TH AVE, SUNRISE, FL 33351-6607
(954) 741-2323
(954) 749-3606
Mailing address
3501 NW 84TH AVE, SUNRISE, FL 33351-6607
(954) 741-2323
(954) 749-3606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5807
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074253800
—
FL
Enumeration date
06/11/2008
Last updated
06/11/2008
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