MEDICARE: DR. THOMAS E HUTSON D.D.S.

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	30.015763	OH

General Provider Information

NPI Number	:	1467402750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS E HUTSON D.D.S.

Provider Business Mailing Address
First Line	:	43 E NORTH ST
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-4027
Country	:	US
Telephone Number	:	614-885-6212
Fax Number	:	614-885-0395

Provider Business Practice Location Address
First Line	:	43 E NORTH ST
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-4027
Country	:	US
Telephone Number	:	614-885-6212
Fax Number	:	614-885-0395

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	11/25/2014

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