Individual
DIANE JEANETTE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3900
(210) 567-3191
Mailing address
3214 ROAN WAY, SAN ANTONIO, TX 78259-2221
(210) 829-7651
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16101
TX
Other
Enumeration date
03/07/2007
Last updated
02/17/2012
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