Jerry L Sullivan DDS PC

NPI 1083697742 - Dentist - 122300000X

NPI Details
NPI 1083697742
Gender Male
Enumeration Date 11/26/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1007 REELFOOT AVE
UNION CITY TN, 38261, US
Phone (731) 885-2277
Fax (731) 885-8852
Business Location
1007 REELFOOT AVE
UNION CITY TN, 38261, US
Phone (731) 885-2277
Fax (731) 885-8852
Toxanomy
Taxonomy Code 122300000X
License State Tennessee
License Number DS1777
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According to our database, Dr. Jerry L Sullivan DDS PC NPI is 1083697742, taxonomy code is 122300000X and license number is DS1777, license state is located at Tennessee. Jerry L Sullivan DDS PC physically located at 1007 Reelfoot Ave, Union City TN, 38261. NPI Number Jerry L Sullivan DDS PC has the Individual type.

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1083697742 NPI number is provided on an as is basis without warranty of any kind. 1083697742 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry L Sullivan DDS PC are for informational purposes only.