Provider Demographics
NPI:1255439501
Name:TUTOR, ALBERT WAYNE JR (DMD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:WAYNE
Last Name:TUTOR
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:25 EASTGATE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2317
Mailing Address - Country:US
Mailing Address - Phone:601-824-3500
Mailing Address - Fax:601-824-6501
Practice Address - Street 1:25 EASTGATE DR
Practice Address - Street 2:SUITE A
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2317
Practice Address - Country:US
Practice Address - Phone:601-824-3500
Practice Address - Fax:601-824-6501
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSOR362-021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics