MEDICARE: TIMOTHY J. HUTCHENS DDS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	16197	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184853384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY J. HUTCHENS DDS, P.A.

Provider Business Mailing Address
First Line	:	7801 BRANDI LN STE B
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-4697
Country	:	US
Telephone Number	:	817-428-6018
Fax Number	:	817-428-8042

Provider Business Practice Location Address
First Line	:	7801 BRANDI LN STE B
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-4697
Country	:	US
Telephone Number	:	817-428-6018
Fax Number	:	817-428-8042

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY J HUTCHENS
Credential	:	DDS
Telephone Number	:	817-428-6018

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	07/08/2009

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