Organization
R. GRAY TUTTLE III, DDS,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REUBEN GRAY TUTTLE III DDS (DDS PLLC)
(336) 768-1712
Entity
Organization
Contact information
Practice address
1341 WESTGATE CENTER DR, SUITE A, WINSTON-SALEM, NC 27103-2934
(336) 768-1712
Mailing address
1341 WESTGATE CENTER DR, SUITE A, WINSTON-SALEM, NC 27103-2934
(336) 768-1712
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
103620
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98655
BCBSNC
NC
Enumeration date
06/25/2006
Last updated
08/22/2020
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