Individual
KELLY FULGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1723 KIRBY PKWY, MEMPHIS, TN 38120-4367
(901) 757-9696
Mailing address
3443 BAILEY CREEK CV S, COLLIERVILLE, TN 38017-9710
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6540
TN
Other
Enumeration date
05/04/2019
Last updated
05/04/2019
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