Provider Demographics
NPI:1689795197
Name:SAUTTER, BARRY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:M
Last Name:SAUTTER
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 1:201 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1464
Mailing Address - Country:US
Mailing Address - Phone:704-376-6470
Mailing Address - Fax:704-496-2915
Practice Address - Street 1:201 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1464
Practice Address - Country:US
Practice Address - Phone:704-376-6470
Practice Address - Fax:704-496-2915
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice