Individual
JULIE R CALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD,PC
Contact information
Practice address
81 BROAD ST # R, LYNN, MA 01902-5020
(781) 593-7665
Mailing address
81 BROAD ST # R, LYNN, MA 01902-5020
(781) 593-7665
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
18299
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18299
DELTA DENTAL
MA
01
—
X10992
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
09/04/2007
Last updated
09/04/2007
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