Healthcare Provider Details

I. General information

NPI: 1033437280
Provider Name (Legal Business Name): DOUGLAS M HUTCHINSON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 SYCAMORE ST
OIL CITY PA
16301-1443
US

IV. Provider business mailing address

217 SYCAMORE ST
OIL CITY PA
16301-1443
US

V. Phone/Fax

Practice location:
  • Phone: 814-670-0374
  • Fax: 814-670-0376
Mailing address:
  • Phone: 814-670-0374
  • Fax: 814-670-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS037921
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: