| Sutton Family Dentistry Llc | |
|
475 Yellowstone Ave Ste D Pocatello ID 83201 | |
| (208) 232-3500 | |
| (208) 232-3505 |
| Full Name | Sutton Family Dentistry Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 475 Yellowstone Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Ernest P Sutton (OWNER) |
| Authorized Official Contact | 2082323500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sutton Family Dentistry Llc 475 Yellowstone Ave Ste D Pocatello ID 83201 Ph: (208) 232-3500 | Sutton Family Dentistry Llc 475 Yellowstone Ave Ste D Pocatello ID 83201 Ph: (208) 232-3500 |
| NPI Number | 1700997947 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 04/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700997947 | NPI | - | NPPES |
| 002732800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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