Provider Demographics
NPI:1699037325
Name:GUTTERY, DARRELL PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:PAUL
Last Name:GUTTERY
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 1:6001 NW 120TH CT
Mailing Address - Street 2:SUITE 8
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162
Mailing Address - Country:US
Mailing Address - Phone:405-721-5757
Mailing Address - Fax:405-721-6783
Practice Address - Street 1:6001 NW 120TH CT
Practice Address - Street 2:SUITE 8
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162
Practice Address - Country:US
Practice Address - Phone:405-721-5757
Practice Address - Fax:405-721-6783
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014143621223G0001X
OK69421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice