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NPI Code Detail

MEDICARE: DR. BRIAN S SUTTON DDS

MEDICARE: DR. BRIAN S SUTTON DDS
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
1122300000XDentist2005015665MO

General Provider Information

NPI Number : 1982624961
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN S SUTTON DDS
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 01/10/2017

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Directions to “ DR. BRIAN S SUTTON DDS” Practice Location

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