Organization
TARA SULLIVAN, DDS PLLC
Active
Other names
THE DENTAL SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
TARA MARIE SULLIVAN DDS (OWNER)
(206) 829-8432
Entity
Organization
Contact information
Practice address
1203 E PINE STREET, SEATTLE, WA 98122
(206) 829-8432
Mailing address
1203 E PINE STREET, SEATTLE, WA 98122
(206) 829-8432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010943
WA
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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