Organization
ROBERT C FULLER DDS & JENNIFER R FULLER DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER R FULLER DDS (DENTIST/OWNER)
(313) 864-9110
Entity
Organization
Contact information
Practice address
334 LIVERNOIS, FERNDALE, MI 48220
(313) 864-9110
(313) 864-8750
Mailing address
334 LIVERNOIS, FERNDALE, MI 48220
(313) 864-9110
(313) 864-8750
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17660
MI
Other
Enumeration date
04/12/2007
Last updated
02/16/2023
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