Maenell Sullivan is a Denturist in Tenino, Washington. Maenell Sullivan practices all healthcare services and medical treatments related to Denturist. The NPI Number for Maenell Sullivan is 1679675367. The last update date is 2007-07-08.
Maenell Sullivan's current location address is Po Box 1051, Tenino, Washington. You can contact this provider via phone number 3602645500 and fax number 3602645500. The mailing address for Maenell Sullivan is Po Box 1051, Tenino, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Maenell Sullivan |
|---|---|
| Address | Po Box 1051, Tenino, Washington |
| Phone Number | 3602645500 |
| Fax Number | 3602645500 |
| Sole Proprietor | N |
| Credentials | DENTURIST |
NPI Number Detail
| NPI Number | 1679675367 |
|---|---|
| Provider Enumeration Date | 2006-09-02 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 1051 |
|---|---|
| City | Tenino |
| State | Washington (WA) |
| Post Code | 98589 |
| Phone Number | 3602645500 |
| Fax Number | 3602645500 |
Provider's Primary Taxonomy Detail
| Speciality | Denturist |
|---|---|
| Taxonomy | 122400000X |
| Licence No | DN361 |
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Definition: A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5045273 | WA | DSHS |
Post Comment/ Review Below
What is the unique identification code assigned to Maenell Sullivan by the Centers for Medicare & Medicaid Services?
The Maenell Sullivan has been issued the NPI (National Provider Identifier) 1679675367. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Maenell Sullivan is physically located?
The Maenell Sullivan is situated at the following address: Po Box 1051, Tenino, WA 98589.
What is the Maenell Sullivan's specialty and taxonomy code?
The Maenell Sullivan's specialty is Denturist, and the corresponding taxonomy code is 122400000X.
When did the Maenell Sullivan receive its 1679675367?
The Maenell Sullivan was issued its 1679675367 on 2006-09-02, which is the date when the organization was assigned this unique identifier.
As of what date were the Maenell Sullivan's details last updated?
The information pertaining to the Maenell Sullivan, including its address, specialty, and other details, was most recently updated on 2007-07-08.