Individual
BRIAN TODD MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
706 BELLE OAK TRL, BRANDON, MS 39042-8205
(166) 254-9795
Mailing address
706 BELLE OAK TRL, BRANDON, MS 39042-8205
(166) 254-9795
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4251-21
MS
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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