Individual
MR. JOHN K SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
498 HARLOW RD, SUITE 1, SPRINGFIELD, OR 97477
(541) 225-4866
(888) 502-2518
Mailing address
498 HARLOW RD, SUITE 1, SPRINGFIELD, OR 97477
(541) 225-4866
(888) 502-2518
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10371
OR
Other
Enumeration date
01/18/2007
Last updated
03/24/2016
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