Individual
DR. CORT PATRICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6785 W 38TH AVE, WHEAT RIDGE, CO 80033
(303) 425-5903
Mailing address
6785 W 38TH AVE, WHEAT RIDGE, CO 80033
(303) 425-5903
(303) 425-6227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105643
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133046
—
CO
Enumeration date
03/02/2007
Last updated
07/09/2007
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