Provider Demographics
NPI:1245373935
Name:RUTLAND, JOHN GRIFFITH (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GRIFFITH
Last Name:RUTLAND
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 1:256 BLOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-1104
Mailing Address - Country:US
Mailing Address - Phone:256-582-5920
Mailing Address - Fax:
Practice Address - Street 1:256 BLOUNT AVE
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-1104
Practice Address - Country:US
Practice Address - Phone:256-582-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL48151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice