Whalio Doctors

NPI 1205104627

John Sullivan, DDS

Practitioner Dentist Tamuning, GU

Practice location

Address
548 S Marine Corps Dr, Tamuning, GU 96913-3539
Phone
(671) 646-5824
Fax
(671) 647-3556
Mailing address
PO Box 6578, Tamuning, GU 96931-6578

Registered specialties

Dentist Primary
Dental Providers Taxonomy 122300000X Licence D930 (GU)

Registry record

NPI
1205104627
Entity type
Individual
Sex (as registered)
Male
NPI issued
13 Dec 2011
Record last updated
13 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.