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General NPI Number Information
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NPI Number | 1760525620
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Entity Type | Organization
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Legal Business Name | SULLIVAN TURNER LLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 736 W SOMERDALE RD
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City | SOMERDALE
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State | NJ
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Zip | 08083-2443
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Country | US
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Telephone | 856-787-3440
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Fax | 856-627-8225
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Provider Business Mailing Address
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Address Line | 736 W SOMERDALE RD
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City | SOMERDALE
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State | NJ
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Zip | 08083-2443
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Country | US
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Telephone | 856-787-3440
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Fax | 856-627-8225
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. CATHERINE M FLEXON
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Credential |
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Telephone | 856-784-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19794
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15377
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License Number State | NJ
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