Stephanie Sullivan Tullos DMD

NPI 1063683472 - Dentist - 122300000X

NPI Details
NPI 1063683472
Gender Female
Enumeration Date 03/13/2008
Last Updated 03/13/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
276 MAGNOLIA DR
RALEIGH MS, 39153-6016, US
Phone (601) 782-9909
Fax (601) 782-9133
Business Location
276 MAGNOLIA DR
RALEIGH MS, 39153-6016, US
Phone (601) 782-9909
Fax (601) 782-9133
Toxanomy
Taxonomy Code 122300000X
License State Mississippi
License Number 3265-03
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According to our database, Dr. Stephanie Sullivan Tullos DMD NPI is 1063683472, taxonomy code is 122300000X and license number is 3265-03, license state is located at Mississippi. Stephanie Sullivan Tullos DMD physically located at 276 Magnolia Dr, Raleigh MS, 39153-6016. NPI Number Stephanie Sullivan Tullos DMD has the Individual type.

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1063683472 NPI number is provided on an as is basis without warranty of any kind. 1063683472 is maintained by the National Plan & Provider Enumeration System. The contents of Stephanie Sullivan Tullos DMD are for informational purposes only.