Organization
GRACIELA K SULLIVAN DDS INC
Active
Other names
Graciela Sullivan DDS. MS. Pediatric Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRACIELA K SULLIVAN D.D.S. (CHIEF EXECUTIVE OFFICER)
(714) 377-2628
Entity
Organization
Contact information
Practice address
5112 WARNER AVE STE 104, HUNTINGTON BEACH, CA 92649-6036
(714) 377-2628
(714) 377-0090
Mailing address
5112 WARNER AVE STE 104, HUNTINGTON BEACH, CA 92649-6036
(714) 377-2628
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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