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Individual

J MICHAEL MUTO II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3860 TEAYS VALLEY RD, SUITE 5, HURRICANE, WV 25526-9772
(304) 757-1000
(304) 757-1091
Mailing address
3860 TEAYS VALLEY RD, SUITE 5, HURRICANE, WV 25526-9772
(304) 757-1000
(304) 757-1091

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3511
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4003058000
WV
Enumeration date
01/23/2006
Last updated
07/08/2007
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