Provider Demographics
NPI:1801971320
Name:HYYTINEN, JEFFREY GORDON (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:GORDON
Last Name:HYYTINEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 16TH AVE. SW
Mailing Address - Street 2:PO BOX 190
Mailing Address - City:RICE
Mailing Address - State:MN
Mailing Address - Zip Code:56367-0190
Mailing Address - Country:US
Mailing Address - Phone:320-393-2215
Mailing Address - Fax:
Practice Address - Street 1:20 16TH AVE. SW
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:MN
Practice Address - Zip Code:56367-0190
Practice Address - Country:US
Practice Address - Phone:320-393-2215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND9464122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist