Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 30-01-8975 | OH |
NPI | 1053486225 |
---|---|
Provider Name | Dr. James T Hutta |
First Address | Gahanna, OH 43230-4555 |
Second Address | Gahanna, OH 43230-4555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 08/07/2007 |