Healthcare Provider Details

I. General information

NPI: 1962624668
Provider Name (Legal Business Name): JOHN E HUTTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 BRIDGE ST SUITE 201
ARROYO GRANDE CA
93420-3307
US

IV. Provider business mailing address

145 BRIDGE ST
ARROYO GRANDE CA
93420-3307
US

V. Phone/Fax

Practice location:
  • Phone: 805-489-1900
  • Fax: 805-489-7867
Mailing address:
  • Phone: 805-489-1900
  • Fax: 805-489-7867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number40357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: