| NPI | 1982865986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN VIRGIL SULLIVANT Doctor 870-425-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR AR2788) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |