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General NPI Number Information
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NPI Number | 1548640568
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Entity Type | Organization
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Legal Business Name | RICHARD W HUETTER DMD INC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 1401 S MAIN ST SUITE 201
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City | NORTH CANTON
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State | OH
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Zip | 44720-4289
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Country | US
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Telephone | 330-499-7997
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Fax | 330-499-7680
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Provider Business Mailing Address
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Address Line | 1401 S MAIN ST SUITE 201
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City | NORTH CANTON
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State | OH
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Zip | 44720-4289
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Country | US
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Telephone | 330-499-7997
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Fax | 330-499-7680
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. RICHARD WILLIAM HUETTER
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Credential | D.M.D.
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Telephone | 330-499-7997
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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 | 16284
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License Number State | OH
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