Provider Demographics
NPI:1881816189
Name:SUTTON, FLETCHER STAMPER III (DDS)
Entity Type:Individual
Prefix:DR
First Name:FLETCHER
Middle Name:STAMPER
Last Name:SUTTON
Suffix:III
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 1:17513 OLD JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3930
Mailing Address - Country:US
Mailing Address - Phone:225-744-7008
Mailing Address - Fax:225-744-7009
Practice Address - Street 1:17513 OLD JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3930
Practice Address - Country:US
Practice Address - Phone:225-744-7008
Practice Address - Fax:225-744-7009
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice