Mark Robert Sullivan DDS

NPI 1407056112 - Dentist - 1223G0001X

NPI Details
NPI 1407056112
Gender Male
Enumeration Date 07/20/2007
Last Updated 05/25/2016
Entity Type Individual
Active Over 9 years ago
Practice Location
54951 MOUND RD
SHELBY TOWNSHIP MI, 48316-6028, US
Phone (586) 797-9118
Fax (586) 797-9085
Business Location
55191 SHELBY RD
SHELBY TOWNSHIP MI, 48316-1150, US
Phone (586) 797-9118
Fax (586) 797-9085
Toxanomy
Taxonomy Code 1223G0001X
License State Michigan
License Number 12343
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According to our database, Dr. Mark Robert Sullivan DDS NPI is 1407056112, taxonomy code is 1223G0001X and license number is 12343, license state is located at Michigan. Mark Robert Sullivan DDS physically located at 54951 Mound Rd, Shelby Township MI, 48316-6028. NPI Number Mark Robert Sullivan DDS has the Individual type.

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1407056112 NPI number is provided on an as is basis without warranty of any kind. 1407056112 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Robert Sullivan DDS are for informational purposes only.