Healthcare Provider Details

I. General information

NPI: 1649932328
Provider Name (Legal Business Name): DENISE L HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2021
Last Update Date: 10/09/2021
Certification Date: 10/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 VALLEY VIEW PKWY
EL DORADO HILLS CA
95762-5536
US

IV. Provider business mailing address

3416 KRAMERS LN TRLR 64
LOUISVILLE KY
40216-4665
US

V. Phone/Fax

Practice location:
  • Phone: 203-857-9481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: