Individual
DR. DAVID JOSEPH SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
413 NW LARCH AVE, SUITE 201, REDMOND, OR 97756-1361
(541) 316-2024
(541) 504-2124
Mailing address
PO BOX 2326, BEND, OR 97709-2326
(541) 316-2024
(541) 504-2124
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D9384
OR
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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