Individual
DR. DANIEL JAMES SULLIVAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
109 N MAIN ST, MOSCOW, PA 18444-9020
(570) 842-4255
(570) 842-0477
Mailing address
109 N MAIN ST, MOSCOW, PA 18444-9020
(570) 842-4255
(570) 842-0477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS019800L
PA
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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