Individual
DR. JOHN H FULMER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
900A MAIN ST, CONWAY, SC 29526-4063
(843) 488-3710
Mailing address
900A MAIN ST, CONWAY, SC 29526-4063
(843) 488-3710
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC2408
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7992952
—
NC
05
—
ZZ2408
—
SC
Enumeration date
07/19/2006
Last updated
07/09/2007
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