Individual
DR. TAYLER DANYELLE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2602 J ST, OMAHA, NE 68107-1643
(402) 733-1325
Mailing address
2537 S 3RD STREET PLZ, OMAHA, NE 68108-1709
(208) 553-6977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7461
NE
1223G0001X
General Practice Dentistry
DDS-09543
IA
Other
Enumeration date
06/01/2018
Last updated
04/09/2019
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