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General NPI Number Information
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NPI Number | 1154870715
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Entity Type | Organization
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Legal Business Name | HUTCHINS DENTAL INC
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 350 N 2ND ST
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City | PORTERVILLE
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State | CA
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Zip | 93257-3847
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Country | US
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Telephone | 559-781-1163
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Fax | 559-784-8205
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Provider Business Mailing Address
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Address Line | 350 N 2ND ST
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City | PORTERVILLE
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State | CA
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Zip | 93257-3847
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Country | US
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Telephone | 559-781-1163
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Fax | 559-784-8205
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Authorized Official
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Title or Position | CEO
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Name | DR. ELWIN ROY HUTCHINS
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Credential | DDS
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Telephone | 559-781-1163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 28867
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License Number State | CA
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