SCOTT R SULLIVAN DDS, MD
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1972134567- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DDS, MD
- Status
- Active
Contact & Location
- Address
- 1103 E MONTCLAIR ST, SPRINGFIELD, MO, 658075076
- Phone
- (316) 616-8157
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
Primary License: MO #2025018574