Provider Demographics
NPI:1316433253
Name:LANCE H. HUTCHENS, D.D.S., M.S., P.A.
Entity type:Organization
Organization Name:LANCE H. HUTCHENS, D.D.S., M.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:910-772-9770
Mailing Address - Street 1:1611 DOCTORS CIR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7405
Mailing Address - Country:US
Mailing Address - Phone:910-772-9770
Mailing Address - Fax:910-772-1553
Practice Address - Street 1:1611 DOCTORS CIRCLE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-2840
Practice Address - Country:US
Practice Address - Phone:910-772-9770
Practice Address - Fax:910-772-1553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental