Provider Demographics
NPI:1093330128
Name:BRIAN S. SUTTON DDS, PC
Entity Type:Organization
Organization Name:BRIAN S. SUTTON DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-931-2342
Mailing Address - Street 1:4546 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1816
Mailing Address - Country:US
Mailing Address - Phone:816-931-2342
Mailing Address - Fax:816-931-1859
Practice Address - Street 1:4546 MAIN ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1816
Practice Address - Country:US
Practice Address - Phone:816-931-2342
Practice Address - Fax:816-931-1859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty