Sullivan Family Dentistry, Llc | |
2186 N Hospital Blvd., Suite 1 Sullivan IN 47882-0468 | |
(812) 268-4010 | |
(812) 268-5607 |
Full Name | Sullivan Family Dentistry, Llc |
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Speciality | Dentist - General Practice |
Location | 2186 N Hospital Blvd., Suite 1, Sullivan, Indiana |
Authorized Official Name and Position | Gregg W Smith (SENIOR PARTNER OWNER) |
Authorized Official Contact | 8122684010 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sullivan Family Dentistry, Llc Po Box 468 Sullivan IN 47882-0468 Ph: (812) 268-4010 | Sullivan Family Dentistry, Llc 2186 N Hospital Blvd., Suite 1 Sullivan IN 47882-0468 Ph: (812) 268-4010 |
NPI Number | 1871996199 |
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Provider Enumeration Date | 10/01/2014 |
Last Update Date | 01/08/2020 |
Identifier | Type | State | Issuer |
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1871996199 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 12007736A (Indiana) | Secondary |
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |