Provider Demographics
NPI:1538235098
Name:SUTTER, VESNA S (DDS)
Entity type:Individual
Prefix:DR
First Name:VESNA
Middle Name:S
Last Name:SUTTER
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 1:502 E STATE ST
Mailing Address - Street 2:SUNRISE DENTAL CARE
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2363
Mailing Address - Country:US
Mailing Address - Phone:630-232-6334
Mailing Address - Fax:630-232-6369
Practice Address - Street 1:7728 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4124
Practice Address - Country:US
Practice Address - Phone:773-745-8300
Practice Address - Fax:630-232-6369
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0201371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice