# JERRY E. SULLINS, DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649442252
- **Authorized official:** DAPHNE POTTER (FRONT OFFICE MANAGER)
- **Authorized official phone:** (615) 824-7220

## Contact information

- **Practice address:** 104 HAZEL PATH, SUITE 1, HENDERSONVILLE, TN 37075-3844
- **Practice address phone:** (615) 824-7220
- **Practice address fax:** (615) 824-9947
- **Mailing address:** 104 HAZEL PATH, SUITE 1, HENDERSONVILLE, TN 37075-3844
- **Mailing address phone:** (615) 824-7220
- **Mailing address fax:** (615) 824-9947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS3056 | TN | Yes |

## Other

- **Enumeration date:** 03/24/2008
- **Last updated:** 03/24/2008