Healthcare Provider Details

I. General information

NPI: 1093904591
Provider Name (Legal Business Name): WILLIAM WINSLOW HUTCHINSON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2007
Last Update Date: 10/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 COLLIER CT 402
MARCO ISLAND FL
34145-6570
US

IV. Provider business mailing address

848 COLLIER CT 402
MARCO ISLAND FL
34145-6570
US

V. Phone/Fax

Practice location:
  • Phone: 239-394-1155
  • Fax: 239-394-1155
Mailing address:
  • Phone: 239-394-1155
  • Fax: 239-394-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 3342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: