Individual provider · Type 1 NPI

Yetta G. McCullom, DDS, MA

Periodontics · Chicago, IL

NPI number 1285884791 Active

Practice location

820 E 87th St, Ste 201
Chicago, IL 60619-6253

Call (773) 488-3738 Map

Fax (773) 874-6575

Specialties and licenses

TaxonomyCodeLicense
Periodontics Primary 1223P0300X021001516 (IL)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1285884791

Yetta G. McCullom, DDS, MA's National Provider Identifier is 1285884791, issued on Sep 22, 2008. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Chicago, IL. The record was last updated on Sep 23, 2008.