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General NPI Number Information
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NPI Number | 1376538462
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Entity Type | Individual
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Provider Name | GREGORY DUANE TUTTLE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 801 3RD ST. SW
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City | DESMET
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State | SD
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Zip | 57231
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Country | US
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Telephone | 605-854-3444
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Fax | 605-854-9952
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Provider Business Mailing Address
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Address Line | 944 HEATHERWOOD AVE
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City | MADISON
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State | SD
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Zip | 57042-3721
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Country | US
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Telephone | 605-556-0035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | M659
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | M659
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | M659
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License Number State | SD
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