Provider Demographics
NPI:1003238866
Name:CULTON, GREGORY M (DMD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:M
Last Name:CULTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1210 E PLAZA BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3628
Mailing Address - Country:US
Mailing Address - Phone:619-477-2787
Mailing Address - Fax:619-477-1682
Practice Address - Street 1:1210 E PLAZA BLVD STE 405
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3628
Practice Address - Country:US
Practice Address - Phone:619-477-2787
Practice Address - Fax:619-477-1682
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA271151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice