| Jackson L. Sullivan D.d.s., P.c. | |
|
609 S Kelly Ave Ste E1 Edmond OK 73003-7501 | |
| (405) 844-8444 | |
| (405) 844-8440 |
| Full Name | Jackson L. Sullivan D.d.s., P.c. |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 609 S Kelly Ave Ste E1, Edmond, Oklahoma |
| Authorized Official Name and Position | Jackson L Sullivan (DOCTOR) |
| Authorized Official Contact | 4058448444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson L. Sullivan D.d.s., P.c. 609 S Kelly Ave Ste E1 Edmond OK 73003-7501 Ph: (405) 844-8444 | Jackson L. Sullivan D.d.s., P.c. 609 S Kelly Ave Ste E1 Edmond OK 73003-7501 Ph: (405) 844-8444 |
| NPI Number | 1336366244 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336366244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 5244 (Oklahoma) | Primary |
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Redbud Dental Edmond, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18001 N Western Ave Ste 106, Edmond, OK 73012 Phone: 405-447-6453 | |
Martha L Garzon Dmd, Ms Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 S Kelly Ave Ste C1, Edmond, OK 73003 Phone: 405-348-5757 Fax: 405-348-8221 | |
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