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Individual
JULIE LYNN FULLENKAMP
Active
Individual
JULIE LYNN FULLENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012935A
IN
1223G0001X
General Practice Dentistry
9337
SC
Other
Enumeration date
06/08/2018
Last updated
04/29/2024
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