Individual
DR. DAREN T SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1231 27TH ST S STE C, FARGO, ND 58103-8722
(701) 232-6983
(701) 239-9375
Mailing address
1231 27TH ST S STE C, FARGO, ND 58103-8722
(701) 232-6983
(701) 239-9375
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2056
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457270
—
ND
05
—
41504
—
ND
Enumeration date
06/22/2009
Last updated
05/17/2016
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