Individual
MICHAEL WARREN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12136 W 87TH ST PKWY, LENEXA, KS 66215-2893
(913) 492-5052
(913) 492-7039
Mailing address
12136 W 87TH ST PKWY, LENEXA, KS 66215-2893
(913) 492-5052
(913) 492-7039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6127
KS
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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