Provider Demographics
NPI:1225126683
Name:SUTER, ROGER PHILLIP II (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:PHILLIP
Last Name:SUTER
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-6013
Mailing Address - Country:US
Mailing Address - Phone:304-623-1888
Mailing Address - Fax:304-624-5500
Practice Address - Street 1:2017 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-6013
Practice Address - Country:US
Practice Address - Phone:304-623-1888
Practice Address - Fax:304-624-5500
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV35371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4005064-000Medicaid