Organization
RUSTY W. SULLINS D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSTY WADE SULLINS D.D.S. (OWNER/PRES.)
(405) 751-9222
Entity
Organization
Contact information
Practice address
4208 COLETTA DR, OKLAHOMA CITY, OK 73120-8317
(405) 751-9222
Mailing address
4208 COLETTA DR, OKLAHOMA CITY, OK 73120-8317
(405) 751-9222
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5243
OK
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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