Provider Demographics
NPI:1689852162
Name:JEFFREY D HUTCHESON, DMD, PA
Entity Type:Organization
Organization Name:JEFFREY D HUTCHESON, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HUTCHESON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-548-1100
Mailing Address - Street 1:8430 UNIVERSITY EXEC PARK DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1350
Mailing Address - Country:US
Mailing Address - Phone:704-548-1100
Mailing Address - Fax:
Practice Address - Street 1:8430 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:SUITE 600
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1350
Practice Address - Country:US
Practice Address - Phone:704-548-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty