Provider Demographics
NPI:1215085568
Name:CULBERSON, JAMES MARION (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARION
Last Name:CULBERSON
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32299 DEEP MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22508-2953
Mailing Address - Country:US
Mailing Address - Phone:540-854-7390
Mailing Address - Fax:
Practice Address - Street 1:12104 SHERATON HILLS DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6748
Practice Address - Country:US
Practice Address - Phone:540-548-2605
Practice Address - Fax:540-548-2606
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010071021223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics