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Individual

DR. JOESPH WARREN FULLER III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1204 N CENTER ST, PERRY, FL 32347-2038
(850) 584-4613
(850) 584-9009
Mailing address
1204 NORTH CENTER STREET, PERRY, FL 32347
(850) 584-4613
(850) 584-9009

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN08166
FL

Other

Enumeration date
10/24/2006
Last updated
09/17/2008
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