Individual
LINDSAY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
443 NW BURNSIDE RD, GRESHAM, OR 97030-3714
(503) 492-8487
Mailing address
443 NW BURNSIDE RD, GRESHAM, OR 97030-3714
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5128
OR
Other
Enumeration date
02/15/2014
Last updated
02/15/2014
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