Individual
JACKIE CALLAWAY-CAMPBELL
Active
Individual
JACKIE CALLAWAY-CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT136
MN
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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