Individual
JOHN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1025 DIVISION ST, SUITE F, BILOXI, MS 39530-2906
(228) 432-5222
(228) 432-5223
Mailing address
517 LEWIS AVE, SUITE 5, GULFPORT, MS 39501-1002
(228) 432-5222
(228) 432-5223
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1701
MS
Other
Enumeration date
04/17/2007
Last updated
02/17/2016
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