NPI | 1407166655 |
---|---|
Other Name | WILLIE MCLULLUM DDS - CHILDREN'S DENTISTRY |
Entity Type | Organization |
Authorized Contact | WILLIE JAMES MCCULLUM Dentist/Owner 253-474-0606 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 6326) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 8920) |
Enumeration Date | 2010-10-20 |
Last Update Date | 2012-12-18 |