Organization
SULLIVAN DENTAL PARTNERSHIP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY D BRACE DMD (DENTIST/OWNER)
(314) 965-7838
Entity
Organization
Contact information
Practice address
300 WALMART DR, SULLIVAN, MO 63080-3333
(573) 860-2552
(573) 860-4553
Mailing address
300 WALMART DR, SULLIVAN, MO 63080-3333
(573) 860-2552
(573) 860-4553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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