Individual
DR. ROBERT JOSEPH O'SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 GREG KRUSCHEK AVENUE, NOME, AK 99762
(907) 443-3311
Mailing address
1000 GREG KRUSCHEK AVENUE, NOME, AK 99762-8754
(907) 443-3311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.033694
IL
1223G0001X
General Practice Dentistry
6001012-15
WI
1223G0001X
General Practice Dentistry
DEN-DEN-LIC-23667
MT
Other
Enumeration date
06/06/2022
Last updated
08/03/2022
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