Individual
DR. CALLAN DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
77 BROAD ST, LYNN, MA 01902-5003
(781) 490-9518
Mailing address
501 CONGRESS ST APT 720, BOSTON, MA 02210-2922
(207) 712-5151
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1859330
MA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
05/09/2020
Last updated
07/20/2022
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