Individual
DR. PREDDIS LEROY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1619 N WATERFRONT PKWY, WICHITA, KS 67206-6602
(316) 462-3354
Mailing address
3620 N CREST CT, WICHITA, KS 67226-1019
(916) 517-9905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
54500
CA
Other
Enumeration date
12/18/2006
Last updated
10/06/2022
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