Individual
DR. BRIAN LAWRENCE SULLIVAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
55 E BROADWAY UNIT 1, DERRY, NH 03038-2401
(603) 548-3865
Mailing address
373 HAVERHILL RD, CHESTER, NH 03036-4209
(603) 548-3865
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
04654
NH
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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