Organization
DRS. MCCULLOM P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YETTA G MCCULLOM DDS (VP AND CHEIF FINANICAL OFFICER)
(773) 488-3738
Entity
Organization
Contact information
Practice address
820 E 87TH ST, SUITE 201, CHICAGO, IL 60619-6253
(773) 488-3738
(773) 874-6575
Mailing address
820 E 87TH ST, SUITE 201, CHICAGO, IL 60619-6253
(773) 488-3738
(773) 874-6575
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
01/30/2007
Last updated
09/11/2025
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