Individual
MICHELLE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3625 UTICA RIDGE RD STE C, BETTENDORF, IA 52722-1653
(563) 259-6040
Mailing address
3625 UTICA RIDGE RD STE C, BETTENDORF, IA 52722-1653
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH-04675
IA
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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