Individual
DR. GREGORY WAYNE MCCULLOUGH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD STE 470, ATLANTA, GA 30342-1717
(404) 254-2709
Mailing address
304 LAKE COURSE DR, AUGUSTA, GA 30904-3422
(470) 814-7790
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123489
GA
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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