Individual
DR. BRADLEY TODD FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
700A BARRETT BLVD, HENDERSON, KY 42420-4931
(270) 827-5522
(270) 827-8272
Mailing address
700A BARRETT BLVD, P.O. BOX 276, HENDERSON, KY 42420-4931
(270) 827-5522
(270) 827-8272
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7040
KY
1223P0221X
Pediatric Dentistry
12009862A
IN
1223P0221X
Pediatric Dentistry
Primary
7040
KY
Other
Enumeration date
01/05/2007
Last updated
02/14/2008
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