Individual
DR. THAD ASHLEY SULLENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
7040 GADSDEN HWY, STE 112, TRUSSVILLE, AL 35173-2680
(205) 655-5219
Mailing address
7040 GADSDEN HWY, STE 112, TRUSSVILLE, AL 35173-2680
(205) 655-5219
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5163
AL
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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