Organization
JERRY E. SULLINS, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAPHNE POTTER (FRONT OFFICE MANAGER)
(615) 824-7220
Entity
Organization
Contact information
Practice address
104 HAZEL PATH, SUITE 1, HENDERSONVILLE, TN 37075-3844
(615) 824-7220
(615) 824-9947
Mailing address
104 HAZEL PATH, SUITE 1, HENDERSONVILLE, TN 37075-3844
(615) 824-7220
(615) 824-9947
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3056
TN
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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