Provider Demographics
NPI:1306026414
Name:SUTTON, KATHRYN L (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:L
Last Name:SUTTON
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 1:419 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1637
Mailing Address - Country:US
Mailing Address - Phone:740-532-6542
Mailing Address - Fax:740-532-2133
Practice Address - Street 1:419 VERNON ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1637
Practice Address - Country:US
Practice Address - Phone:740-532-6542
Practice Address - Fax:740-532-2133
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist