Provider Demographics
NPI:1790066827
Name:CALLENDER, MAUREEN (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:CALLENDER
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5175
Mailing Address - Country:US
Mailing Address - Phone:360-459-5885
Mailing Address - Fax:
Practice Address - Street 1:3422 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5175
Practice Address - Country:US
Practice Address - Phone:360-459-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60285867122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist