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General NPI Number Information
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NPI Number | 1386716447
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Entity Type | Individual
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Provider Name | DR. CALVIN BUFORD SUFFRIDGE
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | NAVAL POSTGRADUATE DENTAL SCHOOL 8955 WOOD ROAD
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City | BETHESDA
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State | MD
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Zip | 20889-1818
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Country | US
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Telephone | 301-295-1831
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Fax |
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Provider Business Mailing Address
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Address Line | 8504 CROSSLEY PL
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City | ALEXANDRIA
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State | VA
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Zip | 22308-1818
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 3182
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License Number State | AR
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