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Organization

DR. DANIEL R CULLUM PA

Active
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Organization

DR. DANIEL R CULLUM PA

Active
Other names
Implants Northwest
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL CULLUM DDS (PRESIDENT)
(208) 667-5565
Entity
Organization

Contact information

Practice address
1859 N LAKEWOOD DR, STE 101, COEUR D ALENE, ID 83814-2661
(208) 667-5565
(208) 765-9633
Mailing address
1859 N LAKEWOOD DR, STE 101, COEUR D ALENE, ID 83814-2661
(208) 667-5565
(208) 765-9633

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D-3149-OS
ID

Other

Enumeration date
08/10/2015
Last updated
08/10/2015
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