Individual
ROBERT LAWRENCE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
40 CHURCH ST, WARE, MA 01082-1234
(413) 967-5833
(413) 967-5933
Mailing address
211 IDUNA LN, AMHERST, MA 01002-3424
(413) 256-6116
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
MA10928
MA
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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