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NPI Profile for MAENELL SULLIVAN in TENINO, WA.
A dental technician specializing in making and fitting dentures as a direct service to the public rather than through a licensed dentist.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Denturist |
122400000X |
| NPI Number | 1679675367 |
|
| Status | Active | |
| Credentials | DENTURIST DPD | |
| Entity | Individual | |
| Enumeration date | 09/02/2006 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MAENELL SULLIVAN
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MAENELL SULLIVAN, DENTURIST DPD