| Graciela Sullivan Dds. Ms. Pediatric Dentist | |
|
5112 Warner Ave Ste 104 Huntington Beach CA 92649-6036 | |
| (714) 377-2628 | |
| (714) 377-0090 |
| Full Name | Graciela Sullivan Dds. Ms. Pediatric Dentist |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5112 Warner Ave Ste 104, Huntington Beach, California |
| Authorized Official Name and Position | Graciela K Sullivan (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7143772628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Graciela Sullivan Dds. Ms. Pediatric Dentist 5112 Warner Ave Ste 104 Huntington Beach CA 92649-6036 Ph: (714) 377-2628 | Graciela Sullivan Dds. Ms. Pediatric Dentist 5112 Warner Ave Ste 104 Huntington Beach CA 92649-6036 Ph: (714) 377-2628 |
| NPI Number | 1316239619 |
|---|---|
| Provider Enumeration Date | 05/05/2011 |
| Last Update Date | 05/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316239619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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