Individual
ELIZABETH ANN FULLNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1897 134TH RD, OSCEOLA, NE 68651-4891
(308) 883-6510
Mailing address
120 W WASHINGTON ST, SHELBY, NE 68662-5651
(308) 883-6510
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2919
NE
Other
Enumeration date
09/01/2022
Last updated
09/29/2023
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