Individual
MRS. ANGELA MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4701 LOGAN AVE, KANSAS CITY, MO 64136-1161
(816) 350-1007
(816) 350-1975
Mailing address
4606 CAMBRIDGE ST, KANSAS CITY, KS 66103-3525
(816) 536-1481
(913) 432-0533
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2008014160
MO
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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