Provider Demographics
NPI:1982963799
Name:JOHN E TRUITT, DDS PC
Entity type:Organization
Organization Name:JOHN E TRUITT, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-789-0230
Mailing Address - Street 1:8249 CROWN COLONY PARKWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116
Mailing Address - Country:US
Mailing Address - Phone:804-789-0230
Mailing Address - Fax:804-789-0734
Practice Address - Street 1:8249 CROWN COLONY PARKWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-789-0230
Practice Address - Fax:804-789-0734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty