| NPI | 1538375175 |
|---|---|
| Former Legal Business Name | JOHN E. SULLIVAN, JR, DDS, MS |
| Entity Type | Organization |
| Authorized Contact | JOHN E SULLIVAN Owner 865-212-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TN 01388) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |