Provider Demographics
NPI:1972674042
Name:DAVID F. SUTTON D.M.D.,P.A.
Entity Type:Organization
Organization Name:DAVID F. SUTTON D.M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-578-3093
Mailing Address - Street 1:2813 S HIAWASSEE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6689
Mailing Address - Country:US
Mailing Address - Phone:407-578-3093
Mailing Address - Fax:407-521-9004
Practice Address - Street 1:2813 S HIAWASSEE RD STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6689
Practice Address - Country:US
Practice Address - Phone:407-578-3093
Practice Address - Fax:407-521-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-12
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN111671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty