| Matthew J Mccullough Dmd Pc | |
|
1300 E City Route 40 Greenville IL 62246-2501 | |
| (618) 664-1483 | |
| Not Available |
| Full Name | Matthew J Mccullough Dmd Pc |
|---|---|
| Speciality | Dentist |
| Location | 1300 E City Route 40, Greenville, Illinois |
| Authorized Official Name and Position | Matthew James Mccullough (PRESIDENT) |
| Authorized Official Contact | 6186641483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew J Mccullough Dmd Pc 1300 E City Route 40 Greenville IL 62246-2501 Ph: (618) 664-1483 | Matthew J Mccullough Dmd Pc 1300 E City Route 40 Greenville IL 62246-2501 Ph: (618) 664-1483 |
| NPI Number | 1245379171 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 05/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245379171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019025298 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 019-025298 (Illinois) | Secondary |