Organization
SULLIVAN & COHEN, P.C.
Active
Other names
Your Dental Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J. SULLIVAN IV D.M.D. (BUSINESS OWNER)
(413) 572-9665
Entity
Organization
Contact information
Practice address
49 SOUTHWICK RD, WESTFIELD, MA 01085-4729
(413) 572-9665
(413) 572-9606
Mailing address
49 SOUTHWICK RD, WESTFIELD, MA 01085-4729
(413) 572-9665
(413) 572-9606
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16639
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11020
BCBSMA GROUP NUMBER
MA
Enumeration date
03/23/2007
Last updated
08/22/2020
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