Organization
SHAWN T MCCULLOUGH DDS, PLLC
Active
Other names
Sun Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN TIMOTHY MCCULLOUGH DDS (OWNER)
(651) 674-4811
Entity
Organization
Contact information
Practice address
6041 MAIN ST STE C, NORTH BRANCH, MN 55056-6589
(651) 674-4811
Mailing address
PO BOX 40, 6041 MAIN STREET, NORTH BRANCH, MN 55056
(651) 674-4811
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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