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CHARLES R. HUTTON D.D.S.,PC

Dental Care Facilities

Winamac, Indiana

Provider NPI: 1083727291

Organization Information:
Organization Name:  CHARLES R. HUTTON D.D.S.,PC
Organization is not Subpart
Authorized Official:  CHARLES RANDALL HUTTON  PRESIDENT  574-9466820

Practice Location:
201 E ADAMS ST  WINAMAC, IN 46996 US
Tel: 574-946-6820  Fax: 574-946-4323

Business Mailing Address:
201 E ADAMS ST  WINAMAC, IN 46996 US
Tel: 574-946-6820  Fax: 574-946-4323

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QD0000XAmbulatory Health Care Facilities
Clinic/Center
Dental
IN54000691A

Other Provider Identifiers:

IssuerNumberStateType
100210570AIN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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