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Organization
D MICHAEL DERUYTER D D S INC
Active
Organization
D MICHAEL DERUYTER D D S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MICHAEL DERUYTER D D S (PRESIDENT)
(870) 867-4110
Entity
Organization
Contact information
Practice address
3447 HIGHWAY 270 E, MOUNT IDA, AR 71957-8092
(870) 867-4110
(870) 867-2207
Mailing address
3447 HIGHWAY 270 E, MOUNT IDA, AR 71957-8092
(870) 867-4110
(870) 867-2207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181483608
—
AR
Enumeration date
02/08/2013
Last updated
02/08/2013
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