| John J Sullivan, Dds, Pc | |
|
325 W White Mountain Blvd Lakeside AZ 85929 | |
| (928) 367-4276 | |
| Not Available |
| Full Name | John J Sullivan, Dds, Pc |
|---|---|
| Speciality | Dentist |
| Location | 325 W White Mountain Blvd, Lakeside, Arizona |
| Authorized Official Name and Position | John J Sullivan (DDS) |
| Authorized Official Contact | 9283674276 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John J Sullivan, Dds, Pc 325 W White Mountain Blvd Lakeside AZ 85929 Ph: (928) 367-4276 | John J Sullivan, Dds, Pc 325 W White Mountain Blvd Lakeside AZ 85929 Ph: (928) 367-4276 |
| NPI Number | 1629254859 |
|---|---|
| Provider Enumeration Date | 01/17/2008 |
| Last Update Date | 04/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629254859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2685 (Arizona) | Primary |