Individual
DR. DANIEL RAY CULLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1859 N LAKEWOOD DR, SUITE 101, COEUR D ALENE, ID 83814-2661
(208) 667-5565
(208) 765-9633
Mailing address
1859 N LAKEWOOD DR, SUITE 101, COEUR D ALENE, ID 83814-2661
(208) 667-5565
(208) 765-9633
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D3149-0S
ID
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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