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General NPI Number Information
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NPI Number | 1730653197
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Entity Type | Organization
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Legal Business Name | MATTHEW CALLAN DDS PLLC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 2530 PERRY AVE STE 100
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City | BREMERTON
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State | WA
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Zip | 98310-5219
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Country | US
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Telephone | 360-479-4050
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Fax |
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Provider Business Mailing Address
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Address Line | 2530 PERRY AVE STE 100
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City | BREMERTON
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State | WA
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Zip | 98310-5219
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Country | US
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Telephone | 360-479-4050
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MATTHEW J CALLAN
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Credential | DDS, MD
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Telephone | 360-479-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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