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Individual

DR. MARK NUTTALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1289 WINCHESTER AVE, REEDSPORT, OR 97467-1373
(888) 468-0022
(541) 504-3907
Mailing address
442 SW UMATILLA AVE, SUITE 200, REDMOND, OR 97756-7039
(888) 480-0022
(541) 504-3907

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10258
OR

Other

Enumeration date
06/19/2015
Last updated
10/06/2015
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