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Individual

DR. ROBERT L FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
761 S 1030 E, OREM, UT 84097-6688
(801) 223-9887
Mailing address
761 S 1030 E, OREM, UT 84097-6688
(801) 223-9887

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
136880-9922
UT

Other

Enumeration date
11/20/2009
Last updated
11/20/2009
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