MEDICARE: DR. MICHAEL B HUTCHESON 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	1223G0001X	General Practice Dentistry	10142	MI

General Provider Information

NPI Number	:	1316937758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL B HUTCHESON DDS

Provider Business Mailing Address
First Line	:	601 S GRAND AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48933-2406
Country	:	US
Telephone Number	:	517-485-1900
Fax Number	:	517-485-0324

Provider Business Practice Location Address
First Line	:	601 S GRAND AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48933-2406
Country	:	US
Telephone Number	:	517-485-1900
Fax Number	:	517-485-0324

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/08/2007

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