# EHLEN & FULLER DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** jack ehlen, dds & julie fuller, dds
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316234735
- **Authorized official:** DR. JULIE FULLER DDS (DENTIST/OWNER)
- **Authorized official phone:** (253) 848-4597

## Contact information

- **Practice address:** 11208 94TH AVE E, SUITE B, PUYALLUP, WA 98373-3663
- **Practice address phone:** (253) 848-4597
- **Mailing address:** 11208 94TH AVE E, SUITE B, PUYALLUP, WA 98373-3663
- **Mailing address phone:** (253) 848-4597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00006157 | WA | — |
| 1223G0001X | General Practice Dentistry | DE60100274 | WA | Yes |

## Other

- **Enumeration date:** 07/06/2011
- **Last updated:** 07/06/2011