MEDICARE: DR. JOSEPH THOMAS LUTTMER DDS

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	1223G0001X	General Practice Dentistry	30012909	OH

General Provider Information

NPI Number	:	1386715811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH THOMAS LUTTMER DDS

Provider Business Mailing Address
First Line	:	2712 ERIE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2111
Country	:	US
Telephone Number	:	513-321-3231
Fax Number	:	513-871-5509

Provider Business Practice Location Address
First Line	:	2712 ERIE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2111
Country	:	US
Telephone Number	:	513-321-3231
Fax Number	:	513-871-5509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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