Organization
BAYOU DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES D CALLAHAN JR. DMD (PRESIDENT)
(850) 476-5233
Entity
Organization
Contact information
Practice address
4461 BAYOU BLVD, PENSACOLA, FL 32503-2601
(850) 476-5233
Mailing address
4461 BAYOU BLVD, PENSACOLA, FL 32503-2601
(850) 476-5233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1808923
UNITED CONCORDIA
FL
Enumeration date
06/10/2006
Last updated
08/22/2020
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