Provider Demographics
NPI:1801860010
Name:HUTCHERSON, CARL F (DMD, FAGD, MAAFO)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:F
Last Name:HUTCHERSON
Suffix:
Gender:M
Credentials:DMD, FAGD, MAAFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MEADOW SPRING RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6935
Mailing Address - Country:US
Mailing Address - Phone:724-832-1835
Mailing Address - Fax:724-832-1836
Practice Address - Street 1:105 MEADOW SPRING RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6935
Practice Address - Country:US
Practice Address - Phone:724-832-1835
Practice Address - Fax:724-832-1836
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020694L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice