Individual
JERRY E SULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
104 HAZEL PATH, HENDERSONVILLE, TN 37075-3844
(615) 824-7220
Mailing address
104 HAZEL PATH, HENDERSONVILLE, TN 37075-3844
(615) 824-7220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3056
TN
Other
Enumeration date
08/10/2006
Last updated
03/20/2008
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