Individual
MR. COLLINS JOSEPH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
967 W 7TH ST, OXNARD, CA 93030-6756
(805) 487-0435
(805) 487-2119
Mailing address
967 W 7TH ST, OXNARD, CA 93030-6756
(805) 487-0435
(805) 487-2119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
033384
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033384
STATE LICENSE
CA
Enumeration date
01/16/2007
Last updated
07/08/2007
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