Individual
DR. MICHAEL KENT FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2102 W RANDOLPH ST, VANDALIA, IL 62471-1973
(618) 283-4900
Mailing address
2102 W RANDOLPH ST, VANDALIA, IL 62471-1973
(618) 283-4900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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