Provider Demographics
NPI:1013515675
Name:TROY A HUTINGER DDS PC
Entity Type:Organization
Organization Name:TROY A HUTINGER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HUTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:660-287-1389
Mailing Address - Street 1:1620 E ROLLINS ST
Mailing Address - Street 2:
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-2478
Mailing Address - Country:US
Mailing Address - Phone:660-263-6642
Mailing Address - Fax:
Practice Address - Street 1:1620 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-2478
Practice Address - Country:US
Practice Address - Phone:660-263-6642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental