Mark R Sullivan DDS
NPI #1851461347 in Shelby Twp, Michigan
Provider Information
- NPI Number
- 1851461347
- Entity Type
- Organization
- Organization Name
- Mark R Sullivan DDS
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 9, 2006
- Last Updated
- Jul 17, 2007
Practice Location
- Address
- 54951 MOUND ROAD
- City
- Shelby Twp
- State
- Michigan
- ZIP Code
- 48316-6028
- Phone
- (586) 797-9118
Authorized Official
- Name
- MARK SULLIVAN
- Title
- DENTIST
- Phone
- (586) 797-9118
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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