Individual provider · Type 1 NPI
Laura Grace Sullivan, DMD
Pediatric Dentistry · St. Johns, FL
NPI number
1649409632
Active
Practice location
1949 Cr 210 W
St. Johns, FL 32259-2062
Fax (904) 342-8113
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | DN18660 (FL) |
| Pediatric Dentistry Primary | 1223P0221X | DN18660 (FL) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Other pediatric dentistry providers in St. Johns
About NPI 1649409632
Laura Grace Sullivan, DMD's National Provider Identifier is 1649409632, issued on Jul 10, 2009. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in St. Johns, FL. The record was last updated on Aug 2, 2013.