Provider Demographics
NPI:1508074592
Name:TUTTLE, TIMOTHY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:TUTTLE
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 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3125
Mailing Address - Country:US
Mailing Address - Phone:609-799-2929
Mailing Address - Fax:609-799-8024
Practice Address - Street 1:330 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-3125
Practice Address - Country:US
Practice Address - Phone:609-799-2929
Practice Address - Fax:609-799-8024
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI012184001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice