Individual
SAMUEL CLIFTON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
160 CRACKER BARRELL DR, BATESVILLE, MS 38606-3031
(662) 563-7821
Mailing address
160 CRACKER BARRELL DR, BATESVILLE, MS 38606-3031
(662) 563-7821
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
112661
MS
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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