Individual
DR. DANIEL JAMES SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
109 N MAIN ST, MOSCOW, PA 18444-9020
(570) 842-4255
Mailing address
109 N MAIN ST, MOSCOW, PA 18444-9020
(570) 842-4255
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS039547
PA
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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