Provider Demographics
NPI:1326560160
Name:ROBERTA A SUHR DDS
Entity Type:Organization
Organization Name:ROBERTA A SUHR DDS
Other - Org Name:SUHR DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SUHR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-746-2238
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:MILLERTON
Mailing Address - State:OK
Mailing Address - Zip Code:74750-0415
Mailing Address - Country:US
Mailing Address - Phone:580-746-2238
Mailing Address - Fax:
Practice Address - Street 1:16333 W US HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:VALLIANT
Practice Address - State:OK
Practice Address - Zip Code:74764-5598
Practice Address - Country:US
Practice Address - Phone:580-746-2238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental