Individual
GABRIEL PAUL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1007 E REELFOOT AVE, UNION CITY, TN 38261
(731) 885-2277
(731) 885-8852
Mailing address
475 N OLD TROY RD, TROY, TN 38260
(731) 536-5210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS8584
TN
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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