Healthcare Provider Details

I. General information

NPI: 1467402750
Provider Name (Legal Business Name): THOMAS E HUTSON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 E NORTH ST
WORTHINGTON OH
43085-4027
US

IV. Provider business mailing address

43 E NORTH ST
WORTHINGTON OH
43085-4027
US

V. Phone/Fax

Practice location:
  • Phone: 614-885-6212
  • Fax: 614-885-0395
Mailing address:
  • Phone: 614-885-6212
  • Fax: 614-885-0395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.015763
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: