Provider Demographics
NPI:1528079555
Name:SUHR, DARRELL REED (DDS)
Entity type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:REED
Last Name:SUHR
Suffix:
Gender:M
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:PO BOX 737
Mailing Address - Street 2:
Mailing Address - City:VALLIANT
Mailing Address - State:OK
Mailing Address - Zip Code:74764-0737
Mailing Address - Country:US
Mailing Address - Phone:580-746-2238
Mailing Address - Fax:580-746-2439
Practice Address - Street 1:RR 2 BOX 328
Practice Address - Street 2:
Practice Address - City:VALLIANT
Practice Address - State:OK
Practice Address - Zip Code:74764-9739
Practice Address - Country:US
Practice Address - Phone:580-746-2238
Practice Address - Fax:580-746-2439
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice