MEDICARE: DR. VICKIE HUTCHINS 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	122300000X	Dentist	16141	TX

General Provider Information

NPI Number	:	1710980636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICKIE HUTCHINS D.D.S

Provider Business Mailing Address
First Line	:	3939 W GREEN OAKS BLVD
Second Line	:	STE 102
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2792
Country	:	US
Telephone Number	:	817-446-5242
Fax Number	:

Provider Business Practice Location Address
First Line	:	3939 W GREEN OAKS BLVD
Second Line	:	STE 102
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2792
Country	:	US
Telephone Number	:	817-446-5242
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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