Jeffrey J Mccullough, DMD, MS Valid NPI

Individual provider · Periodontics · Los Alamitos, CA

NPI

1497179253

Type

Individual (Type 1)

Primary specialty

Periodontics (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223P0300X

License number

62289 (CA)

Sex

Male

Sole proprietor

Yes

Enumerated

2014-02-13

Last updated

2018-06-10