Individual
DR. JAMES WOODFIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 KANEOHE LN, BASTROP, TX 78602-7252
(512) 775-0395
Mailing address
121 KANEOHE LN, BASTROP, TX 78602-7252
(512) 988-6942
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17117
TX
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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