Individual
BRUCE E. SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
145 RAILROAD AVE, NORWOOD, MA 02062-3525
(781) 551-9434
Mailing address
145 RAILROAD AVE, NORWOOD, MA 02062-3525
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17364
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0277401
—
MA
Enumeration date
11/01/2006
Last updated
07/08/2007
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