Provider Demographics
NPI:1073646709
Name:MCCALLEN, JAMES FRANCIS III (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANCIS
Last Name:MCCALLEN
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:960 STATE ROUTE 212
Mailing Address - Street 2:
Mailing Address - City:TIPTONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38079-4037
Mailing Address - Country:US
Mailing Address - Phone:731-253-5000
Mailing Address - Fax:731-253-5190
Practice Address - Street 1:960 STATE ROUTE 212
Practice Address - Street 2:
Practice Address - City:TIPTONVILLE
Practice Address - State:TN
Practice Address - Zip Code:38079-4037
Practice Address - Country:US
Practice Address - Phone:731-253-5000
Practice Address - Fax:731-253-5190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 37741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3225837Medicaid