Scott Louis Sullivan DDS

NPI 1063612844 - Dentist - 1223G0001X

NPI Details
NPI 1063612844
Gender Male
Enumeration Date 07/20/2007
Last Updated 07/20/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
76 DOCTORS PARK DR.
SANTA ROSA CA, 95405-6615, US
Phone (707) 546-6367
Fax (707) 542-7829
Business Location
76 DOCTORS PARK DR.
SANTA ROSA CA, 95405, US
Phone (707) 546-6367
Fax (707) 542-7829
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 44095
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According to our database, Dr. Scott Louis Sullivan DDS NPI is 1063612844, taxonomy code is 1223G0001X and license number is 44095, license state is located at California. Scott Louis Sullivan DDS physically located at 76 Doctors Park Dr., Santa Rosa CA, 95405-6615. NPI Number Scott Louis Sullivan DDS has the Individual type.

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1063612844 NPI number is provided on an as is basis without warranty of any kind. 1063612844 is maintained by the National Plan & Provider Enumeration System. The contents of Scott Louis Sullivan DDS are for informational purposes only.