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Organization

ALBERT W. TUTOR, JR., D.M.D. PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALBERT WAYNE TUTOR JR. D.M.D. (ORTHODONTIST)
(601) 824-3500
Entity
Organization

Contact information

Practice address
25 EASTGATE DR, SUITE A, BRANDON, MS 39042-2317
(601) 824-3500
(601) 824-3501
Mailing address
25 EASTGATE DR, SUITE A, BRANDON, MS 39042-2317
(601) 824-3500
(601) 824-3501

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3161-00
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00660444
MS
Enumeration date
04/13/2009
Last updated
04/13/2009
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