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Dr. Andrea Lee Sullivan, DMD
General Practice Dentistry in Glen Carbon, Illinois
NPI 1871092502

Andrea Lee Sullivan is a General Practice Dentistry based in O Fallon, IL and is specialized in General Practice. Andrea Lee Sullivan practices in Glen Carbon, IL and has the professional credentials of DMD. The NPI Number for Andrea Lee Sullivan is 1871092502 and holds a License No. 2018003588 (Illinois).

The current practice location address for Andrea Lee Sullivan is 3024 South Il-159, Glen Carbon, IL and can be reached out via phone at 855-579-2158.

Location: 3024 South Il-159, Glen Carbon, IL, 62269-2833
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871092502
Provider Name
Andrea Lee Sullivan
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
3024 South Il-159, Glen Carbon, IL, 62269-2833
Phone Number
855-579-2158
Fax Number
Provider Enumeration Date
02/08/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2018003588 01 MO MISSOURI DENTAL BOARD
institution
Provider Business Practice Location Address Details
Address
3024 South Il-159
City
Glen Carbon
State
Illinois
Zip
62034
Phone Number
855-579-2158
Fax Number
person
Provider Business Mailing Address Details
Address
3024 South Il-159
City
Glen Carbon
State
Illinois
Zip
62034
Phone Number
855-579-2158
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2018003588 (Missouri)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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