Provider Demographics
NPI:1407171747
Name:SUFFIELD, PETER M (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:SUFFIELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7438 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4195
Mailing Address - Country:US
Mailing Address - Phone:513-891-4324
Mailing Address - Fax:513-891-4327
Practice Address - Street 1:7438 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4195
Practice Address - Country:US
Practice Address - Phone:513-891-4324
Practice Address - Fax:513-891-4327
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0225991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics