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Individual

JOSEPH VINCENT SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2109 CUMING ST, OMAHA, NE 68102-4325
(406) 250-7093
(406) 250-7093
Mailing address
2109 CUMING ST, OMAHA, NE 68102-4325
(402) 280-5990

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7685
NE
1223G0001X
General Practice Dentistry
DE60232759
WA

Other

Enumeration date
09/07/2011
Last updated
09/21/2023
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