Provider Demographics
NPI:1235238742
Name:SUTTON, JOE ED (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:ED
Last Name:SUTTON
Suffix:
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:PO BOX 1238 507 S MAIN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77562
Mailing Address - Country:US
Mailing Address - Phone:281-426-7591
Mailing Address - Fax:281-426-5246
Practice Address - Street 1:507 S MAIN
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:TX
Practice Address - Zip Code:77562
Practice Address - Country:US
Practice Address - Phone:281-426-7591
Practice Address - Fax:281-426-5246
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice