Individual
DR. SHELLY REA SULLENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
121 SW 5TH ST, CANYONVILLE, OR 97417-8718
(888) 468-0022
(541) 504-3907
Mailing address
442 SW UMATILLA AVE, SUITE 200, REDMOND, OR 97756-7039
(541) 504-3900
(541) 504-3907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6207
OR
Other
Enumeration date
02/03/2009
Last updated
06/23/2015
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