Individual
DR. JOHN FULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
90 MEDICAL CENTER DR STE 100, SUPPLY, NC 28462-3669
(910) 269-2420
Mailing address
90 MEDICAL CENTER DR STE 100, SUPPLY, NC 28462-3669
(717) 817-3235
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11562
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2016
Last updated
03/06/2022
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