Individual
DR. JOHN MICHAEL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D, M.S.
Contact information
Practice address
9770 OLD BAYMEADOWS RD STE 113, JACKSONVILLE, FL 32256-7986
(904) 636-8999
(904) 998-7804
Mailing address
9770 OLD BAYMEADOWS RD STE 113, JACKSONVILLE, FL 32256-7986
(904) 636-8999
(904) 998-7804
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18659
FL
Other
Enumeration date
07/14/2009
Last updated
12/18/2012
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