# PRIMROSE DENTAL GROUP, PLLC

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

## Provider details

- **NPI number:** 1831002724
- **Authorized official:** JACKSON FULLER DDS (OWNER)
- **Authorized official phone:** (208) 206-9375

## Contact information

- **Practice address:** 3522 DENTON HWY, HALTOM CITY, TX 76117-3210
- **Practice address phone:** (817) 918-4470
- **Mailing address:** 2600 VILLAGE PKWY STE 120, HIGHLAND VILLAGE, TX 75077-3285

## Taxonomy

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

## Other

- **Enumeration date:** 09/23/2026
- **Last updated:** 09/23/2026