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NPI Code Detail

MEDICARE: BRIAN S. SUTTON DDS, PC

MEDICARE: BRIAN S. SUTTON DDS, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1093330128
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIAN S. SUTTON DDS, PC
Provider Business Mailing Address
First Line : 4546 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1816
Country : US
Telephone Number : 816-931-2342
Fax Number : 816-931-1859
Provider Business Practice Location Address
First Line : 4546 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1816
Country : US
Telephone Number : 816-931-2342
Fax Number : 816-931-1859
Authorized Official
Title or Position : OWNER
Name : DR. BRIAN S. SUTTON
Credential : DDS
Telephone Number : 816-931-2342
Provider Enumeration Date : 06/15/2020
Last Update Date : 06/15/2020

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