Provider Demographics
NPI:1578226767
Name:PETER H SUTTON DENTISTRY PLLC
Entity Type:Organization
Organization Name:PETER H SUTTON DENTISTRY PLLC
Other - Org Name:TRUE SMILE ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-512-0020
Mailing Address - Street 1:9073 WEST STATE HWY 29
Mailing Address - Street 2:103
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78628
Mailing Address - Country:US
Mailing Address - Phone:859-512-0020
Mailing Address - Fax:
Practice Address - Street 1:9073 WEST STATE HWY 29
Practice Address - Street 2:103
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:859-512-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty