| Jacob Sullivan, | |
|
2050a 2nd St Se, Kirtland Afb, NM 87117-5522 | |
| (505) 846-3200 | |
| Not Available |
| Full Name | Jacob Sullivan |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 2050a 2nd St Se, Kirtland Afb, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922633080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D010709 (Arizona) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Sullivan, 2050a 2nd St Se, Kirtland Afb, NM 87117-5901 Ph: () - | Jacob Sullivan, 2050a 2nd St Se, Kirtland Afb, NM 87117-5522 Ph: (505) 846-3200 |
Dr. Lynn Michael Johnson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-2466 | |
Brett Mason Harrell, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 937-818-5346 | |
Satpal S Jutla, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-3200 | |
Ronald Nelson, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a Second Street Se, Kirtland Afb, NM 87117 Phone: 505-846-2607 | |
Dr. John Keith Paul Iii, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050 A Second St. Se, 377 Mdg, Kirtland Afb, NM 87117 Phone: 505-846-3055 | |
Mariah Gordon, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-3200 | |
Dr. Steven C. Fenzl, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 377 Dental Sq/sgd, 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-2548 Fax: 505-846-2428 |