Matthew J Mccullough Dmd PC

NPI #1245379171 in Greenville, Illinois

Provider Information

NPI Number: 1245379171
Entity Type: Organization
Organization Name: Matthew J Mccullough Dmd PC
Primary Specialty: Dentist
Enumeration Date: Feb 6, 2007
Last Updated: May 7, 2015

Practice Location

Address: 1300 E CITY ROUTE 40
City: Greenville
State: Illinois
ZIP Code: 62246-2501
Phone: (618) 664-1483

Authorized Official

Name: DR. MATTHEW JAMES MCCULLOUGH, D.M.D.
Title: PRESIDENT
Phone: (618) 664-1483

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist	122300000X	Primary

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