Douglas a Tutterow DDS PA

Organization Active NPI General Practice Dentistry · Pfafftown, NC

NPI 1306980362 · NPPES record last updated Jun 12, 2008

Key facts

NPI
1306980362
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
5245 (NC)
Legal business name
DOUGLAS A TUTTEROW DDS PA
Practice address
4680 Yadkinville Rd
Pfafftown, NC 27040-8622
Phone
(336) 924-9555
Fax
(336) 924-3168
NPI assigned
Feb 16, 2007
Organization subpart
No

Authorized official

Name
Dr. Douglas Alan Tutterow, DDS
Title
President
Phone
(336) 924-9555

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

4680 Yadkinville Rd
Pfafftown, NC 27040
Phone (336) 924-9555

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 5245 NC Yes

Addresses

Primary practice location

4680 Yadkinville Rd
Pfafftown, NC 27040-8622

Mailing address

4680 Yadkinville Rd
Pfafftown, NC 27040-8622
Phone (336) 924-9555

Other identifiers

IdentifierTypeStateIssuer
4998654MedicaidNC

Other providers in Pfafftown, NC

All providers in Pfafftown, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.