Provider Demographics
NPI:1578727426
Name:SUTT, ERIK L (DMD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:L
Last Name:SUTT
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 1:2015 RESERVOIR ST STE C
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8739
Mailing Address - Country:US
Mailing Address - Phone:540-434-2102
Mailing Address - Fax:540-434-0300
Practice Address - Street 1:2015 RESERVOIR ST STE C
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8739
Practice Address - Country:US
Practice Address - Phone:540-434-2102
Practice Address - Fax:540-434-0300
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA401410563122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA437439OtherANTHEM