Sullivan, Laura Grace
Sullivan, Laura Grace is an individual health care provider with primary practice located at 1949 Cr 210 W , Saint Johns FL 32259-2062. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Sullivan, Laura Grace can be contacted via phone (904) 402-4409.Contact Information
Primary practice address
1949 Cr 210 W
Saint Johns FL 32259-2062
Phone: (904) 402-4409
Fax: (904) 342-8113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN18660 | Florida |
| Dental Providers / Pediatric Dentistry | 1223P0221X | DN18660 | Florida |
Profile Details
| NPI number | 1649409632 |
|---|---|
| LBN Legal business name | Sullivan, Laura Grace |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2009 |
| Last updated | Aug 2nd, 2013 - about 13 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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