Individual
KYLE COLLEDGE TUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
1508 E SKYLINE DR STE 200, SOUTH OGDEN, UT 84405-4849
(801) 627-0500
Mailing address
1785 N 4100 W, PLAIN CITY, UT 84404-8093
(435) 253-0376
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11841617-9921
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DEN.00204577
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2018
Last updated
03/31/2023
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