Individual
ETHAN DUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 RAINBOW DR, MADISON, AL 35758-8224
(256) 289-8255
Mailing address
115 RAINBOW DR, MADISON, AL 35758-8224
(256) 289-8255
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
006831AL
AL
Other
Enumeration date
11/11/2020
Last updated
03/04/2025
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