Shawn Timothy Mccullough, DDS

NPI #1023171196 in North Branch, Minnesota

Provider Information

NPI Number: 1023171196
Entity Type: Individual
Name: Shawn Timothy Mccullough, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Dec 19, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 6041 MAIN STREET
Address 2: SUITE C
City: North Branch
State: Minnesota
ZIP Code: 55056
Phone: (651) 674-4811

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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