Healthcare Provider Details

I. General information

NPI: 1003267261
Provider Name (Legal Business Name): STEVEN HUTT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 W 124TH AVE STE 130
WESTMINSTER CO
80234-1718
US

IV. Provider business mailing address

905 W 124TH AVE STE 130
WESTMINSTER CO
80234-1718
US

V. Phone/Fax

Practice location:
  • Phone: 303-920-4900
  • Fax: 303-920-4823
Mailing address:
  • Phone: 303-920-4900
  • Fax: 303-920-4823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN00202817
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: