Healthcare Provider Details

I. General information

NPI: 1295955862
Provider Name (Legal Business Name): H MCNEILL HUTSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 UNIVERSITY BLVD STE C
HARRISONBURG VA
22801-3751
US

IV. Provider business mailing address

129 UNIVERSITY BLVD. STE. C
HARRISONBURG VA
22801
US

V. Phone/Fax

Practice location:
  • Phone: 540-434-1125
  • Fax: 540-574-3356
Mailing address:
  • Phone: 540-434-1125
  • Fax: 540-574-3356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401-005666
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: