Individual
IGOR KUTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8321 W OVERLAND RD, BOISE, ID 83709-1640
(208) 605-3638
Mailing address
8321 W OVERLAND RD, BOISE, ID 83709-1640
(208) 605-3638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02950300
NJ
122300000X
Dentist
D-11984
OR
122300000X
Dentist
Primary
D-5480
ID
122300000X
Dentist
DGD9990
SC
122300000X
Dentist
DN26171
FL
Other
Enumeration date
07/09/2021
Last updated
01/29/2025
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