| Tara Sullivan, Dds Pllc | |
|
1203 E Pine Street Seattle WA 98122 | |
| (206) 829-8432 | |
| Not Available |
| Full Name | Tara Sullivan, Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1203 E Pine Street, Seattle, Washington |
| Authorized Official Name and Position | Tara Marie Sullivan (OWNER) |
| Authorized Official Contact | 2068298432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Sullivan, Dds Pllc 1203 E Pine Street Seattle WA 98122 Ph: (206) 829-8432 | Tara Sullivan, Dds Pllc 1203 E Pine Street Seattle WA 98122 Ph: (206) 829-8432 |
| NPI Number | 1215295498 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 04/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215295498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00010943 (Washington) | Primary |
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