| Sullivan Dentistry,llc | |
|
920 Greenwald Ct Ste 300 Mukwonago WI 53149-1711 | |
| (262) 642-2296 | |
| Not Available |
| Full Name | Sullivan Dentistry,llc |
|---|---|
| Speciality | Dentist |
| Location | 920 Greenwald Ct, Mukwonago, Wisconsin |
| Authorized Official Name and Position | John S Sullivan (OWNER) |
| Authorized Official Contact | 2626422296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sullivan Dentistry,llc N9225 S Shore Dr East Troy WI 53120-2178 Ph: (262) 642-2296 | Sullivan Dentistry,llc 920 Greenwald Ct Ste 300 Mukwonago WI 53149-1711 Ph: (262) 642-2296 |
| NPI Number | 1780877571 |
|---|---|
| Provider Enumeration Date | 08/24/2007 |
| Last Update Date | 08/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780877571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5098-015 (Wisconsin) | Primary |