Provider Demographics
NPI:1376708909
Name:CULLINAN, CHRISTOPHER R (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:CULLINAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 CABOT ST
Mailing Address - Street 2:SUITE 5&6
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5723
Mailing Address - Country:US
Mailing Address - Phone:978-922-5134
Mailing Address - Fax:
Practice Address - Street 1:234 CABOT ST
Practice Address - Street 2:SUITE 5&6
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5723
Practice Address - Country:US
Practice Address - Phone:978-922-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice