Trinity River Dental Professional Corporation

NPI #1326354754 in Wichita, Kansas

Provider Information

NPI Number: 1326354754
Entity Type: Organization
Organization Name: Trinity River Dental Professional Corporation
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 23, 2010
Last Updated: Oct 6, 2022

Practice Location

Address: 1619 N WATERFRONT PKWY
City: Wichita
State: Kansas
ZIP Code: 67206-6602
Phone: (916) 517-9905

Authorized Official

Name: DR. PREDDIS LEROY SULLIVAN, DDS
Title: PRESIDENT
Phone: (916) 517-9905

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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