Provider Demographics
NPI:1710323621
Name:HOUNSHELL, BRANDON CULLER (D,D,S)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:CULLER
Last Name:HOUNSHELL
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 1:209 PATTON DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-4658
Mailing Address - Country:US
Mailing Address - Phone:704-482-7739
Mailing Address - Fax:704-482-5800
Practice Address - Street 1:209 PATTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4658
Practice Address - Country:US
Practice Address - Phone:704-482-7739
Practice Address - Fax:704-482-5800
Is Sole Proprietor?:No
Enumeration Date:2013-05-18
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice