Organization
MATTHEW J MCCULLOUGH, DMD, 3 LLC
Active
Other names
Great River Dental-East Alton
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCCULLOUGH DMD (PRESIDENT)
(618) 339-7248
Entity
Organization
Contact information
Practice address
96 S 9TH ST, EAST ALTON, IL 62024-1715
(618) 259-1400
Mailing address
96 S 9TH ST, EAST ALTON, IL 62024-1715
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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