Brian Stuart Cullen, D.M.D.

Individual provider Active NPI General Practice Dentistry · Edgartown, MA

NPI 1679625255 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1679625255
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
13440 (MA)
Practice address
258 Edgartown Rd.
Unit 2
Edgartown, MA 02539
Phone
(508) 627-6464
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13440MAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13440 MA Yes

Addresses

Primary practice location

258 Edgartown Rd.
Unit 2
Edgartown, MA 02539

Mailing address

PO Box 1845
Edgartown, MA 02539-1845
Phone (508) 627-6464

Other providers in Edgartown, MA

All providers in Edgartown, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.