Organization
JAY L. NUTT & C. FRED PIETSCH, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
C FRED PIETSCH DDS (PRESIDENT)
(972) 690-8617
Entity
Organization
Contact information
Practice address
1231 E BELT LINE RD, SUITE 103, RICHARDSON, TX 75081-3748
(972) 690-8617
(972) 690-6423
Mailing address
1231 E BELT LINE RD, SUITE 103, RICHARDSON, TX 75081-3748
(972) 690-8617
(972) 690-6423
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10340
TX
122300000X
Dentist
10482
TX
1223P0300X
Periodontics
19473
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12807
TX
Other
Enumeration date
03/06/2007
Last updated
09/11/2025
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