Sullivan, Kenneth

Sullivan, Kenneth is an sole proprietor health care provider with primary practice located at 2439 Bloomfield Rd , Cape Girardeau MO 63703-6415. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Sullivan, Kenneth can be contacted via phone (573) 335-5199.

Contact Information

Primary practice address
2439 Bloomfield Rd Cape Girardeau MO 63703-6415
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2006013084 Missouri

Profile Details

NPI number 1689756272
LBN Legal business name Sullivan, Kenneth
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2006
Last updated Sep 10th, 2008 - about 17 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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