MEDICARE: CAMERON DUTT DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019.032796	IL

General Provider Information

NPI Number	:	1225656564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON DUTT DDS

Provider Business Mailing Address
First Line	:	3440 OHIO ST
Second Line	:
City	:	GREAT LAKES
State	:	IL
Zip	:	60088-3155
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3475 N SARATOGA ST
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98278-3155
Country	:	US
Telephone Number	:	360-257-2302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	11/17/2022

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Directions to “ CAMERON DUTT DDS” Practice Location

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