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Organization
RAYMONDVILLE DENTAL
Active
Organization
RAYMONDVILLE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ROBERT SULLIVAN DDS (OWNER)
(956) 699-3999
Entity
Organization
Contact information
Practice address
957 E HIDALGO AVE, STE. # B2, RAYMONDVILLE, TX 78580-4149
(956) 699-3999
(956) 699-3901
Mailing address
957 E HIDALGO AVE, STE. # B2, RAYMONDVILLE, TX 78580-4149
(956) 699-3999
(956) 699-3901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30177
TX
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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