Organization
HENDERSON CHILDREN'S DENTISTRY, LLC
Active
Other names
Henderson Children's Dentistry, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD FULKERSON DMD (MEMBER/OWNER)
(270) 827-5522
Entity
Organization
Contact information
Practice address
700 BARRET BLVD STE A, HENDERSON, KY 42420-7526
(270) 827-5522
(270) 827-8272
Mailing address
PO BOX 276, HENDERSON, KY 42419-0276
(270) 827-5522
(270) 827-8272
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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