Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | D010249 | AZ |
NPI | 1780043059 |
---|---|
Provider Name | Danielle Culpepper |
First Address | Green Valley, AZ 85614-3773 |
Second Address | Brooklyn, NY 11220-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2016 |
Last Update Date | 29/08/2019 |