Organization
BEACON DENTAL CENTER GAYLORD
Active
Other names
Beacon Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A SULLIVAN DDS (OWNER / DOCTOR)
(231) 547-9141
Entity
Organization
Contact information
Practice address
1723 W M 32, BUILDING B, GAYLORD, MI 49735-9544
(989) 448-2802
(231) 547-5077
Mailing address
6483 M 66 N, CHARLEVOIX, MI 49720-9272
(231) 547-9141
(231) 547-5077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13522
MI
1223G0001X
General Practice Dentistry
Primary
19909
MI
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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