Individual
JESSICA KAY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2727 1ST AVE SE, CEDAR RAPIDS, IA 52402-4844
(319) 363-3575
Mailing address
2727 1ST AVE SE, CEDAR RAPIDS, IA 52402-4844
(319) 363-3575
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS-08981
IA
Other
Enumeration date
08/06/2009
Last updated
02/04/2016
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