Provider Demographics
NPI:1063717502
Name:HITTSON, SUZANNE L (DDS)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:L
Last Name:HITTSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NORTH GOLIAD
Mailing Address - Street 2:SUITE # 107
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087
Mailing Address - Country:US
Mailing Address - Phone:972-771-3753
Mailing Address - Fax:972-534-1230
Practice Address - Street 1:3301 NORTH GOLIAD
Practice Address - Street 2:SUITE 107
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:972-771-3753
Practice Address - Fax:972-543-1230
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice