Larry D Sullivan is a Dentist in Willits, California. Larry D Sullivan practices all healthcare services and medical treatments related to Dentist. The NPI Number for Larry D Sullivan is 1003986928. The last update date is 2007-07-08.
Larry D Sullivan's current location address is 45 Hazel St, Willits, California. You can contact this provider via phone number 7074569700 and fax number 7074569585. The mailing address for Larry D Sullivan is 45 Hazel St, Willits, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry D Sullivan |
|---|---|
| Address | 45 Hazel St, Willits, California |
| Phone Number | 7074569700 |
| Fax Number | 7074569585 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1003986928 |
|---|---|
| Provider Enumeration Date | 2006-11-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 45 Hazel St |
|---|---|
| City | Willits |
| State | California (CA) |
| Post Code | 954904222 |
| Phone Number | 7074569700 |
| Fax Number | 7074569585 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 18646 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code issued to Larry D Sullivan by the Centers for Medicare & Medicaid Services?
The Larry D Sullivan has been assigned the NPI (National Provider Identifier) 1003986928 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Larry D Sullivan's physical address?
The Larry D Sullivan is physically located at 45 Hazel St, in the city of Willits, CA, with the postal code 954904222.
What is the area of specialization for Larry D Sullivan, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Larry D Sullivan is Dentist, and the corresponding taxonomy code that categorizes this area of expertise is 122300000X.
On what date did the Larry D Sullivan receive the assignment of its 1003986928 from the Centers for Medicare & Medicaid Services?
The Larry D Sullivan was issued its 1003986928 by the Centers for Medicare & Medicaid Services on 2006-11-08.
As of what date was the information regarding Larry D Sullivan, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Larry D Sullivan, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
NPI Number: 1982607784
Address: 54045 Ridge Rd, Yucca Valley, CA