Individual
DR. BRIAN KELLY HUTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2301 ST PAULS WAY, MODESTO, CA 95355-3309
(209) 522-5238
(209) 522-4703
Mailing address
2301 ST PAULS WAY, MODESTO, CA 95355-3309
(209) 522-5238
(209) 522-4703
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12798
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
62106
CA
Other
Enumeration date
08/10/2007
Last updated
02/04/2024
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