Provider Demographics
NPI:1730120734
Name:SUTTER, EDWARD GEORGE SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:GEORGE
Last Name:SUTTER
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1422 SENECA ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2830
Mailing Address - Country:US
Mailing Address - Phone:206-323-7659
Mailing Address - Fax:206-323-4668
Practice Address - Street 1:1001 BROADWAY
Practice Address - Street 2:SUITE 311
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4397
Practice Address - Country:US
Practice Address - Phone:206-323-7659
Practice Address - Fax:206-323-4668
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA28911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice