Individual
REBECCA MAYNARD SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 412-2787
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14178
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2023
Last updated
08/06/2025
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