Individual
DR. MICHAEL STEVEN FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2441 21ST STREET, CDR, U.S. ARMY DENTAL ACTIVITY, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Mailing address
2441 21ST STREET, CDR, U.S. ARMY DENTAL ACTIVITY, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5739
KY
Other
Enumeration date
12/02/2005
Last updated
09/20/2012
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