John J Sullivan, Dds, PC

NPI #1629254859 in Lakeside, Arizona

Provider Information

NPI Number: 1629254859
Entity Type: Organization
Organization Name: John J Sullivan, Dds, PC
Primary Specialty: Dentist
Enumeration Date: Jan 17, 2008
Last Updated: Apr 21, 2010

Practice Location

Address: 325 W WHITE MOUNTAIN BLVD
City: Lakeside
State: Arizona
ZIP Code: 85929
Phone: (928) 367-4276

Authorized Official

Name: JOHN J SULLIVAN, DDS
Title: DDS
Phone: (928) 367-4276

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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