James Francis McCallen III, D.D.S.

Individual provider Active NPI General Practice Dentistry · Tiptonville, TN

NPI 1073646709 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1073646709
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS 3774 (TN)
Practice address
960 State Route 212
Tiptonville, TN 38079-4037
Phone
(731) 253-5000
Fax
(731) 253-5190
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS 3774TNMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS 3774 TN Yes

Addresses

Primary practice location

960 State Route 212
Tiptonville, TN 38079-4037

Mailing address

960 State Route 212
Tiptonville, TN 38079-4037
Phone (731) 253-5000

Other identifiers

IdentifierTypeStateIssuer
3225837MedicaidTN

Other providers in Tiptonville, TN

All providers in Tiptonville, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.