Individual
DR. MORDENA T SULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1099 MARTIN LUTHER KING JR., DRIVE, ATLANTA, GA 30314
(404) 752-7777
(404) 752-6877
Mailing address
P O BOX 50101, ATLANTA, GA 30302
(404) 752-7777
(404) 752-6877
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10426
GA
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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