Individual
JODIE D CALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
201 MAIN, MARSING, ID 83639
(208) 896-4159
(208) 466-5359
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 461-7149
(208) 466-5359
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5146
ID
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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