Provider Demographics
NPI:1760897490
Name:SUITT, THOMAS POSHIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:POSHIA
Last Name:SUITT
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 1:650 PONCE DE LEON AVE NE STE 600B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1856
Mailing Address - Country:US
Mailing Address - Phone:404-874-0800
Mailing Address - Fax:
Practice Address - Street 1:650 PONCE DE LEON AVE NE STE 600B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1856
Practice Address - Country:US
Practice Address - Phone:404-874-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014696122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist