Derek Dutson, D.M.D

NPI 1548796527 · on the registry since 2017

Practice

Address: 90 Hope Dr
Mountain Home Afb, ID 83648
Phone: (208) 828-7300
Organisation at this address: Mt Home Refill Phcy
366th Medical Group Sgsl
366th Medgrp-Mountain Home
366th Medgrp-Mountain Home
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 90

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Also registered as: 122300000X
Licence states on file: UT
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2018-08-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho