Provider Demographics
NPI:1760490858
Name:SUTTON, WILLIAM M (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:SUTTON
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 1:1002 HARVEY RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4220
Mailing Address - Country:US
Mailing Address - Phone:253-833-2290
Mailing Address - Fax:253-887-8706
Practice Address - Street 1:1002 HARVEY RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4220
Practice Address - Country:US
Practice Address - Phone:253-833-2290
Practice Address - Fax:253-887-8706
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA41381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice