Provider Demographics
NPI:1659314300
Name:SHUTE, GEORGE A II (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:SHUTE
Suffix:II
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 1:5314 S YALE AVE
Mailing Address - Street 2:#410
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5314 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6271
Practice Address - Country:US
Practice Address - Phone:918-492-7343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK45321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice