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Organization
MICHAEL T. FULBRIGHT DDS A PROFESSIONAL CORPORATION
Active
Organization
MICHAEL T. FULBRIGHT DDS A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL FULBRIGHT DDS (PRESIDENT/OWNER)
(310) 316-4477
Entity
Organization
Contact information
Practice address
1815 VIA EL PRADO, #200, REDONDO BEACH, CA 90277-5722
(310) 316-4477
Mailing address
1815 VIA EL PRADO, #200, REDONDO BEACH, CA 90277-5722
(310) 316-4477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
47892
CA
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/23/2015
Last updated
10/14/2015
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