Healthcare Provider Details

I. General information

NPI: 1235122391
Provider Name (Legal Business Name): STEVEN T HUTCHERSON DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 S MILLER ST SUITE J
SANTA MARIA CA
93454-6923
US

IV. Provider business mailing address

1414 S MILLER ST SUITE J
SANTA MARIA CA
93454-6923
US

V. Phone/Fax

Practice location:
  • Phone: 805-922-9626
  • Fax: 805-922-9177
Mailing address:
  • Phone: 805-922-9626
  • Fax: 805-922-9177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number27769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: