Provider Demographics
NPI:1457648214
Name:CULPEPPER, ROBERT BRENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRENT
Last Name:CULPEPPER
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 1:701 N 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-3348
Mailing Address - Country:US
Mailing Address - Phone:601-649-3344
Mailing Address - Fax:
Practice Address - Street 1:701 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-3348
Practice Address - Country:US
Practice Address - Phone:601-649-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3584-111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice