Organization
JEANNINE CULLUM DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNINE CULLUM DDS (PRESIDENT)
(936) 275-3101
Entity
Organization
Contact information
Practice address
214 E MAIN ST, SAN AUGUSTINE, TX 75972-2032
(936) 275-3101
(936) 275-1551
Mailing address
214 E MAIN ST, SAN AUGUSTINE, TX 75972-2032
(936) 275-3101
(936) 275-1551
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18319
TX
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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