Individual
DR. GRACIELA KUATA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS., MS
Contact information
Practice address
5112 WARNER AVE, SUITE 104, HUNTINGTON BEACH, CA 92649-6036
(714) 377-2628
(714) 377-0090
Mailing address
5112 WARNER AVE, SUITE 104, HUNTINGTON BEACH, CA 92649-6036
(714) 377-2628
(714) 377-0090
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
50535
CA
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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