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:
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Health care specialties

SpecialtyCodeLicense #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 11 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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