Brian Todd Mccullough

NPI #1417629817 in Brandon, Mississippi

Provider Information

NPI Number: 1417629817
Entity Type: Individual
Name: Brian Todd Mccullough
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 4, 2021
Last Updated: Oct 4, 2021

Practice Location

Address: 706 BELLE OAK TRL
City: Brandon
State: Mississippi
ZIP Code: 39042-8205
Phone: (166) 254-9795

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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