Individual
SARA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3097 STEINWAY ST, 2ND FLOOR, ASTORIA, NY 11103-3440
(718) 545-5100
(888) 292-7017
Mailing address
15 ENGLE ST, SUITE 303, ENGLEWOOD, NJ 07631-2936
(201) 308-8181
(201) 875-5588
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
02602900
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
057913
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
11391
CT
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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