Provider Demographics
NPI:1932878931
Name:DR CARA MCCALLUM PLLC
Entity type:Organization
Organization Name:DR CARA MCCALLUM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-658-6293
Mailing Address - Street 1:9956 W REMINGTON PL # A10-172
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7641 SHAFFER PKWY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3013
Practice Address - Country:US
Practice Address - Phone:303-989-0577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental