Provider Demographics
NPI:1245455989
Name:HUTSON, JAMES (DDS PC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HUTSON
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 WHITLOCK AVE.
Mailing Address - Street 2:B-22
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4656
Mailing Address - Country:US
Mailing Address - Phone:770-424-7525
Mailing Address - Fax:770-424-9326
Practice Address - Street 1:707 WHITLOCK AVE SW
Practice Address - Street 2:B-22
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3000
Practice Address - Country:US
Practice Address - Phone:770-424-7525
Practice Address - Fax:770-424-9326
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0101421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice