Provider Demographics
NPI:1457503245
Name:HUT DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:HUT DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTABARAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-572-9696
Mailing Address - Street 1:PO BOX 5004
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-5004
Mailing Address - Country:US
Mailing Address - Phone:630-572-9696
Mailing Address - Fax:630-572-9743
Practice Address - Street 1:120 OAK BROOK CENTER MALL
Practice Address - Street 2:SUITE 625
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1806
Practice Address - Country:US
Practice Address - Phone:630-572-9696
Practice Address - Fax:630-572-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060-0053941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty