| 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 |