Individual
JACKIE CALLAWAY-CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
405 BABCOCK BLVD E STE 130, DELANO, MN 55328-9144
(763) 276-1410
(763) 276-1411
Mailing address
414 7TH ST SE APT 103, MINNEAPOLIS, MN 55414-1272
(302) 598-3863
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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