Organization
EHLEN & FULLER DDS PLLC
Active
Other names
jack ehlen, dds & julie fuller, dds
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE FULLER DDS (DENTIST/OWNER)
(253) 848-4597
Entity
Organization
Contact information
Practice address
11208 94TH AVE E, SUITE B, PUYALLUP, WA 98373-3663
(253) 848-4597
Mailing address
11208 94TH AVE E, SUITE B, PUYALLUP, WA 98373-3663
(253) 848-4597
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DE00006157
WA
1223G0001X
General Practice Dentistry
Primary
DE60100274
WA
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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