Provider Demographics
NPI:1649476003
Name:CULP, CHRISTINE LOUISE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:CULP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 CHATHAM RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4402
Mailing Address - Country:US
Mailing Address - Phone:847-729-9778
Mailing Address - Fax:
Practice Address - Street 1:620 CHATHAM RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4402
Practice Address - Country:US
Practice Address - Phone:847-729-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007980A122300000X
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist