Provider Demographics
NPI:1902244254
Name:SUITER, EMILY (DDS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SUITER
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 1:500 LENTZ DR
Mailing Address - Street 2:SUITE 40
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5135
Mailing Address - Country:US
Mailing Address - Phone:615-868-9057
Mailing Address - Fax:615-868-0234
Practice Address - Street 1:500 LENTZ DR
Practice Address - Street 2:SUITE 40
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5135
Practice Address - Country:US
Practice Address - Phone:615-868-9057
Practice Address - Fax:615-868-0234
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN100111223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry