Individual
FABIAN FULLER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
264 NEW SHACKLE ISLAND RD STE 105A, HENDERSONVILLE, TN 37075-2482
(615) 477-5011
Mailing address
264 NEW SHACKLE ISLAND RD STE 105A, HENDERSONVILLE, TN 37075-2482
(615) 477-5011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12053
TN
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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