| NPI | 1508302167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HUGH SULLIVAN Dentist 615-373-1012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 5042) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 10036) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |