Jacob Sullivan
General Dentistry · Kirtland Afb, NM
UnclaimedNPI 1922633080
- Primary taxonomy
- 122300000X
- Enumerated
- 2020-03-10
- Practice location
- Kirtland Afb, NM
- Last NPPES update
- 2021-09-28
State licenses
- AZ · Dentist · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.