Healthcare Provider Details

I. General information

NPI: 1356262174
Provider Name (Legal Business Name): ASHLEY DODSON CULOTTA LDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 BATTLEGROUND AVE STE 200
GREENSBORO NC
27408-8342
US

IV. Provider business mailing address

1209 BATTLEGROUND AVE STE 200
GREENSBORO NC
27408-8342
US

V. Phone/Fax

Practice location:
  • Phone: 336-852-7107
  • Fax:
Mailing address:
  • Phone: 336-852-7107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number2238
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: