Individual
DR. EMMA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9055 S ROBERTS RD, HICKORY HILLS, IL 60457-3812
(709) 598-4055
Mailing address
9055 S ROBERTS RD, HICKORY HILLS, IL 60457-3812
(708) 598-4055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019034322
IL
Other
Enumeration date
07/12/2023
Last updated
08/05/2024
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