Callaway Family Dental LLC

NPI #1699484840 in Fulton, Missouri

Provider Information

NPI Number: 1699484840
Entity Type: Organization
Organization Name: Callaway Family Dental LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Nov 16, 2022
Last Updated: Nov 16, 2022

Practice Location

Address: 2424 N BLUFF ST
City: Fulton
State: Missouri
ZIP Code: 65251-2709
Phone: (573) 642-6904

Authorized Official

Name: ALEX MADOV, DDS
Title: MEMBER
Phone: (402) 850-9285

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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