Sullivan Dentistry,llc

NPI #1780877571 in Mukwonago, Wisconsin

Provider Information

NPI Number: 1780877571
Entity Type: Organization
Organization Name: Sullivan Dentistry,llc
Primary Specialty: Dentist
Enumeration Date: Aug 24, 2007
Last Updated: Aug 24, 2007

Practice Location

Address: 920 GREENWALD CT
Address 2: STE 300
City: Mukwonago
State: Wisconsin
ZIP Code: 53149-1711
Phone: (262) 642-2296

Authorized Official

Name: DR. JOHN S SULLIVAN, DDS
Title: OWNER
Phone: (262) 642-2296

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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