Provider Demographics
NPI:1629218722
Name:CULOTTA, VINCENT (D,D,S,)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:CULOTTA
Suffix:
Gender:M
Credentials:D,D,S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 E JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3241
Mailing Address - Country:US
Mailing Address - Phone:410-665-8044
Mailing Address - Fax:
Practice Address - Street 1:3132 E JOPPA RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3241
Practice Address - Country:US
Practice Address - Phone:410-665-8044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9250122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist