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Organization

CHARLES R. HUTTON D.D.S.,PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES RANDALL HUTTON D.D.S. (PRESIDENT)
(574) 946-6820
Entity
Organization

Contact information

Practice address
201 E ADAMS ST, WINAMAC, IN 46996-1567
(574) 946-6820
(574) 946-4323
Mailing address
201 E ADAMS ST, WINAMAC, IN 46996-1567
(574) 946-6820
(574) 946-4323

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
54000691A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100210570A
IN
Enumeration date
08/15/2006
Last updated
03/12/2015
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