MEDICARE: DR. PAUL ALAN SUTTON DMD

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
1	1223G0001X	General Practice Dentistry	22DI01352500	NJ

General Provider Information

NPI Number	:	1376559344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL ALAN SUTTON DMD

Provider Business Mailing Address
First Line	:	1400 BROAD ST
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3012
Country	:	US
Telephone Number	:	973-338-3101
Fax Number	:	973-338-8001

Provider Business Practice Location Address
First Line	:	1400 BROAD ST
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3012
Country	:	US
Telephone Number	:	973-338-3101
Fax Number	:	973-338-8001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/08/2007

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