# SANDRA L. FULLER,DDS,P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326051707
- **Authorized official:** SANDRA FULLER DDS (PRES.)
- **Authorized official phone:** (336) 379-1206

## Contact information

- **Practice address:** 1515 W CORNWALLIS DR, GREENSBORO, NC 27408-6338
- **Practice address phone:** (336) 379-1206
- **Practice address fax:** (336) 379-1733
- **Mailing address:** 1515 W CORNWALLIS DR, GREENSBORO, NC 27408-6338
- **Mailing address phone:** (336) 379-1206
- **Mailing address fax:** (336) 379-1733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6821 | NC | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 08/22/2020