Individual
DR. JENNIFER CHANG SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S., MSD
Contact information
Practice address
35 BEDFORD ST STE 20, LEXINGTON, MA 02420-4440
(617) 468-8696
Mailing address
35 BEDFORD ST STE 20, LEXINGTON, MA 02420-4440
(617) 468-8696
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1859858
MA
1223P0300X
Periodontics
26373
TX
1223P0300X
Periodontics
S125
MN
Other
Enumeration date
02/22/2013
Last updated
10/01/2023
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