Provider Demographics
NPI:1235122391
Name:HUTCHERSON, STEVEN T (DDS, MS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:T
Last Name:HUTCHERSON
Suffix:
Gender:M
Credentials:DDS, MS
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1414 S MILLER ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6923
Mailing Address - Country:US
Mailing Address - Phone:805-922-9626
Mailing Address - Fax:805-922-9177
Practice Address - Street 1:1414 S MILLER ST
Practice Address - Street 2:SUITE J
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6923
Practice Address - Country:US
Practice Address - Phone:805-922-9626
Practice Address - Fax:805-922-9177
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2011-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA277691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB27769-01OtherCA DENTICAL & HEALTHY FAM