Organization Name: | JOHN D.O'CULL DENTISTRY P.S.C. |
NPI Number: | 1962696187 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN DARRELL O'CULL (OWNER) |
Mailing Address: | Route 3037 Vanceburg |
State: | KY US |
Postal Code: | 41179 |
Phone Number: | 6067963811 |
Fax Number: | 6067962221 |
NPI Enumeration Date: | 08/30/2007 |
NPI Last Update Date: | 08/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 5556 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |