Individual
MR. ROGER BARRETT SULLIVAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
449 N GRAND ST, SCHOOLCRAFT, MI 49087-9141
(269) 679-5285
Mailing address
PO BOX 237, 449 N. GRAND ST, SCHOOLCRAFT, MI 49087-0237
(269) 679-5285
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13518
MI
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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