Individual
DR. TERENCE KEVIN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
206 HIGHLAND PARK PLZ, COVINGTON, LA 70433-7129
(985) 892-3310
(985) 892-2578
Mailing address
206 HIGHLAND PARK PLZ, COVINGTON, LA 70433-7129
(985) 892-3310
(985) 892-2578
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2764
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1827649
—
LA
Enumeration date
04/18/2007
Last updated
07/08/2007
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