Sullivan, Jacob

Sullivan, Jacob is an individual health care provider with primary practice located at 2050A 2Nd St Se , Kirtland Afb NM 87117-5522. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Sullivan, Jacob can be contacted via phone (505) 846-3200.

Contact Information

Primary practice address
2050A 2Nd St Se Kirtland Afb NM 87117-5522
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D010709 Arizona

Profile Details

NPI number 1922633080
LBN Legal business name Sullivan, Jacob
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2020
Last updated Sep 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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