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Organization
L. TEMP SULLIVAN DDS PLLC
Active
Organization
L. TEMP SULLIVAN DDS PLLC
Active
Other names
Sullivan Dental Co
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY GRAVES (PRACTICE ADMINISTRATOR)
(615) 469-0887
Entity
Organization
Contact information
Practice address
4219 HILLSBORO PIKE STE 107, NASHVILLE, TN 37215-3309
(615) 469-0887
(615) 469-0152
Mailing address
4219 HILLSBORO PIKE STE 107, NASHVILLE, TN 37215-3309
(615) 469-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/21/2022
Last updated
08/29/2022
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