Organization
SULLIVAN FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGG W SMITH DDS (SENIOR PARTNER OWNER)
(812) 268-4010
Entity
Organization
Contact information
Practice address
2186 N HOSPITAL BLVD., SUITE 1, SULLIVAN, IN 47882-0468
(812) 268-4010
(812) 268-5607
Mailing address
PO BOX 468, SULLIVAN, IN 47882-0468
(812) 268-4010
(812) 268-5607
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12007736A
IN
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/01/2014
Last updated
01/08/2020
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