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Organization
KYLE D SULLIVAN, DMD, PLLC
Active
Organization
KYLE D SULLIVAN, DMD, PLLC
Active
Other names
Sullivan Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE SULLIVAN DMD (OWNER/DENTIST)
(509) 525-3522
Entity
Organization
Contact information
Practice address
121 W POPLAR ST STE A, WALLA WALLA, WA 99362-2871
(509) 525-3522
(509) 525-0518
Mailing address
121 W POPLAR ST STE A, WALLA WALLA, WA 99362-2871
(509) 525-3522
(509) 525-0518
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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