Provider Demographics
NPI:1679838429
Name:CULP, DANIELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:CULP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W. ERIE STREET, SUITE 200
Mailing Address - Street 2:DENTAL DREAMS LLC C/O JULIETTE BOYCE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:698 CRESCENT ST
Practice Address - Street 2:DENTAL DREAMS, LLC
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3360
Practice Address - Country:US
Practice Address - Phone:617-997-5492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856016122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist