Organization
DR. JOHN V. SULLIVANT, D.D.S. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN VIRGIL SULLIVANT DDS (DOCTOR)
(870) 425-4242
Entity
Organization
Contact information
Practice address
727 N CARDINAL DR, MOUNTAIN HOME, AR 72653-3253
(870) 425-4242
(870) 425-4243
Mailing address
727 N CARDINAL DR, MOUNTAIN HOME, AR 72653-3253
(870) 425-4242
(870) 425-4243
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AR2788
AR
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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