Provider Demographics
NPI:1912033242
Name:TUTTLE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:TUTTLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-681-2893
Mailing Address - Street 1:8631 W 150TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2974
Mailing Address - Country:US
Mailing Address - Phone:913-681-2893
Mailing Address - Fax:913-685-4266
Practice Address - Street 1:8631 W 150TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2974
Practice Address - Country:US
Practice Address - Phone:913-681-2893
Practice Address - Fax:913-685-4266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60245261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental