Organization
RAWLEY H. FULLER, IV, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAWLEY HARRISON FULLER IV DDS, PA (DENTIST & OWNER)
(336) 226-0855
Entity
Organization
Contact information
Practice address
3450 FORESTDALE DR., BURLINGTON, NC 27215-9142
(336) 226-0855
(336) 226-0137
Mailing address
3450 FORESTDALE DR., BURLINGTON, NC 27215-9142
(336) 226-0855
(336) 226-0137
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6491
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8992953
—
NC
Enumeration date
11/15/2006
Last updated
12/19/2014
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