Provider Demographics
NPI:1275638884
Name:FUTRELL, HARRY C (DMD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:C
Last Name:FUTRELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WEST 23RD STREET
Mailing Address - Street 2:STE J
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405
Mailing Address - Country:US
Mailing Address - Phone:850-769-3427
Mailing Address - Fax:850-769-5575
Practice Address - Street 1:330 WEST 23RD STREET
Practice Address - Street 2:STE J
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-769-3427
Practice Address - Fax:850-769-5575
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLORIDA7128122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist