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General NPI Number Information
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NPI Number | 1871925503
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Entity Type | Organization
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Legal Business Name | CULPEPPER FAMILY DENTISTRY
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Dates
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Enumeration Date | 08/05/2013
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Last Update Date | 08/05/2013
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Provider Practice Location Address
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Address Line | 620 N 13TH ST
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City | ROGERS
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State | AR
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Zip | 72756-3434
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Country | US
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Telephone | 479-936-8877
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Fax |
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Provider Business Mailing Address
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Address Line | 620 N 13TH ST
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City | ROGERS
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State | AR
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Zip | 72756-3434
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Country | US
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Telephone | 479-936-8877
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. NICHOLAS MCRAE CULPEPPER
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Credential | D.D.S
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Telephone | 870-219-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3954
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License Number State | AR
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