Provider Demographics
NPI:1518042829
Name:SUTTON, EDWARD COLEMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:COLEMAN
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 1:7429 N. FIRST
Mailing Address - Street 2:#102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-261-0745
Mailing Address - Fax:559-224-6749
Practice Address - Street 1:7429 N. FIRST
Practice Address - Street 2:#102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-261-0745
Practice Address - Fax:559-224-6749
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice