Individual
DR. DEBRA FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
817 FEDERAL ST, CAMDEN, NJ 08103-1539
(856) 583-2496
Mailing address
PO BOX 2742, TOLEDO, OH 43606-0742
(419) 841-0656
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02734700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0696813
—
OH
01
—
18632
OHIO STATE DENTAL LICENSE
OH
Enumeration date
02/18/2007
Last updated
04/27/2021
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