JACOB SULLIVAN

KIRTLAND AFB, NM
NPI1922633080
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: AZ  D010709)
Enumeration Date2020-03-10
Last Update Date2021-09-28
Business Address
JACOB SULLIVAN
2050A 2ND ST SE
KIRTLAND AFB, NM 87117-5522
Phone number: 505-846-3200
Mailing Address
JACOB SULLIVAN
2050A 2ND ST SE
KIRTLAND AFB, NM 87117-5901
Phone number:
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