Individual
STEVEN RICHARD CLUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7524 S ANTHONY BLVD, FORT WAYNE, IN 46816-2517
(260) 441-8500
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1201063A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200800010
—
IN
05
—
2618206
—
OH
Enumeration date
05/09/2006
Last updated
12/27/2010
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