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1417527995
AUSTIN MCCULLOUGH
POCATELLO, ID
NPI
1417527995
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: ID D-5283)
Enumeration Date
2021-06-28
Last Update Date
2021-06-28
Business Address
AUSTIN MCCULLOUGH DDS
921 S 8TH AVE STOP 8088
POCATELLO, ID 83209-0002
Phone number: 208-282-6000
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Mailing Address
AUSTIN MCCULLOUGH DDS
856 E CARTER ST APT 6 DOWNSTAIRS UNDER THE PORCH
POCATELLO, ID 83201-5371
Phone number: 218-849-4128
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