# DECATUR FAMILY DENTISTRY 2.0

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Decatur Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548056922
- **Authorized official:** FORREST FULLENKAMP DDS (OWNER)
- **Authorized official phone:** (260) 223-7533

## Contact information

- **Practice address:** 1020 SOUTHAMPTON DR, DECATUR, IN 46733-1049
- **Practice address phone:** (260) 223-7533
- **Mailing address:** 1020 SOUTHAMPTON DR, DECATUR, IN 46733-1049
- **Mailing address phone:** (260) 223-7533

## Taxonomy

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

## Other

- **Enumeration date:** 04/15/2025
- **Last updated:** 04/22/2025