Individual
DIANE K CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
74 ECLIPSE CTR, BELOIT, WI 53511-3550
(608) 361-6048
Mailing address
74 ECLIPSE CTR, BELOIT, WI 53511-3550
(608) 361-6048
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5539016
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5539016
STATE OF WISCONSIN LICENSE NUMBER
WI
Enumeration date
03/20/2009
Last updated
03/20/2009
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