| NPI | 1639593254 |
|---|---|
| Doing Business As | THERESA SULLIVAN GONZALES DMD MS MSS |
| Entity Type | Organization |
| Authorized Contact | THERESA GONZALES Director 843-792-4496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-02-18 |