Provider Demographics
NPI:1588798540
Name:TUTTLE, STEPHEN CALDWELL (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CALDWELL
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9982 SCRIPPS RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1825
Mailing Address - Country:US
Mailing Address - Phone:858-566-8510
Mailing Address - Fax:858-566-8384
Practice Address - Street 1:9982 SCRIPPS RANCH BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1825
Practice Address - Country:US
Practice Address - Phone:858-566-8510
Practice Address - Fax:858-566-8384
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA238771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice