Provider Demographics
NPI:1972768885
Name:HUTCHISON, DANA REED (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:REED
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 C AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118
Mailing Address - Country:US
Mailing Address - Phone:619-435-6231
Mailing Address - Fax:619-435-4447
Practice Address - Street 1:120 C AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118
Practice Address - Country:US
Practice Address - Phone:619-435-6231
Practice Address - Fax:619-435-4447
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist