Provider Demographics
NPI:1033973128
Name:CAMERON DUTT, PLLC
Entity Type:Organization
Organization Name:CAMERON DUTT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-793-6516
Mailing Address - Street 1:5326 93RD PL NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-2648
Mailing Address - Country:US
Mailing Address - Phone:701-793-6516
Mailing Address - Fax:
Practice Address - Street 1:6456 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:WA
Practice Address - Zip Code:98236
Practice Address - Country:US
Practice Address - Phone:360-341-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental