Provider Demographics
NPI:1376935536
Name:HUTCHINSON DENTAL CTR P.A.
Entity type:Organization
Organization Name:HUTCHINSON DENTAL CTR P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:DD
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:320-587-3993
Mailing Address - Street 1:2 FRANKLIN ST SW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-2419
Mailing Address - Country:US
Mailing Address - Phone:320-587-3993
Mailing Address - Fax:320-587-0600
Practice Address - Street 1:2 FRANKLIN ST SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-2419
Practice Address - Country:US
Practice Address - Phone:320-587-3993
Practice Address - Fax:320-587-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43247881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty