Provider Demographics
NPI:1851472096
Name:SUTTON, ALEX (DDS)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32105 1ST AVE S
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5719
Mailing Address - Country:US
Mailing Address - Phone:253-838-4880
Mailing Address - Fax:253-826-2329
Practice Address - Street 1:32105 1ST AVE S
Practice Address - Street 2:SUITE B-1
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5719
Practice Address - Country:US
Practice Address - Phone:253-838-4880
Practice Address - Fax:253-826-2329
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000072041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice