Organization
KENT CUTFORTH DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERT KENT CUTFORTH D.D.S. (DENTIST/OWNER)
(208) 523-3388
Entity
Organization
Contact information
Practice address
1370 E. 17TH STREET, IDAHO FALLS, ID 83404
(208) 523-3388
(208) 535-0995
Mailing address
1370 E. 17TH STREET, IDAHO FALLS, ID 83404
(208) 523-3388
(208) 535-0995
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001169300
—
ID
05
—
808413300
—
ID
Enumeration date
09/11/2009
Last updated
11/05/2009
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