Individual
DR. DAVID M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
40 CHURCH AVE, WAREHAM, MA 02571-2093
(508) 273-0110
(508) 273-0112
Mailing address
40 CHURCH AVE, WAREHAM, MA 02571-2093
(508) 273-0110
(508) 273-0112
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
19523
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04614
DELTA DENTAL
MA
01
—
05029
DELTA DENTAL
RI
01
—
1364146
UNITED CONCORDIA
PA
01
—
22189
DELTA DENTAL
NJ
01
—
50503
ALTUS
RI
01
—
60054
AETNA
KY
01
—
62308
CIGNA
TN
01
—
64246
GUARDIAN
WA
01
—
65978
METLIFE
TX
01
—
70408
ASSURANT EMPLOYEE BENEFIT
IA
01
—
70408
FORTIS
ID
01
—
77777
DELTA DENTAL
CA
01
—
CB870
BLUECROSS BLUESHIELD
RI
01
—
CBAL1
BLUECROSS BLUESHIELD
AL
01
—
CDMIO
DELTA DENTAL
MI
01
—
DDPFS
DELTA DENTAL FEDERAL
CA
01
—
X12120
BLUECROSS BLUESHIELD
MA
Enumeration date
07/11/2006
Last updated
07/08/2007
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