| Organization Name: | CHARLES R. HUTTON D.D.S.,PC |
| NPI Number: | 1083727291 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES RANDALL HUTTON (PRESIDENT) |
| Mailing Address: | 201 E Adams St Winamac |
| State: | IN US |
| Postal Code: | 469961567 |
| Phone Number: | 5749466820 |
| Fax Number: | 5749464323 |
| NPI Enumeration Date: | 08/15/2006 |
| NPI Last Update Date: | 03/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 54000691A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |