# JULIE R CALLUM DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427033422
- **Authorized official:** DR. JULIE ROSE CALLUM DMD (OWNER/OPERATOR)
- **Authorized official phone:** (781) 593-7665

## Contact information

- **Practice address:** 81 BROAD ST \# R, LYNN, MA 01902-5020
- **Practice address phone:** (781) 593-7665
- **Practice address fax:** (781) 593-8344
- **Mailing address:** 81R BROAD ST, LYNN, MA 01902-5003
- **Mailing address phone:** (781) 593-7665
- **Mailing address fax:** (781) 593-8344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 18299 | MA | Yes |

## Other

- **Enumeration date:** 12/13/2005
- **Last updated:** 09/04/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 18299 | DELTA DENTAL PROVIDER ID | — |
| 01 | — | X10992 | BCBS OF MA PROVIDER ID | — |