Provider Demographics
NPI:1568569275
Name:STURGEON, DAVID BIFORD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BIFORD
Last Name:STURGEON
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 1:3905 SOUTHLAND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3864
Mailing Address - Country:US
Mailing Address - Phone:765-455-0875
Mailing Address - Fax:765-455-2590
Practice Address - Street 1:3905 SOUTHLAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3864
Practice Address - Country:US
Practice Address - Phone:765-455-0875
Practice Address - Fax:765-455-2590
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006858A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice