Individual
DR. CLAYTON MATTHEW FULKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
118 MAPLE ROW BLVD STE B, HENDERSONVILLE, TN 37075-3824
(615) 824-8929
(615) 822-3330
Mailing address
118 MAPLE ROW BLVD STE B, HENDERSONVILLE, TN 37075-3824
(615) 824-8929
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS0000009092
TN
Other
Enumeration date
04/13/2009
Last updated
10/24/2018
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