Individual
MS. TANYA HUTCHISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5415 DISTINCTION WAY, PRESCOTT, AZ 86301-8438
(928) 350-8045
Mailing address
5415 DISTINCTION WAY, PRESCOTT, AZ 86301-8438
(928) 350-8045
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
12/12/2017
Last updated
12/12/2017
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