Individual
DR. BRIAN SCOTT FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1920 S 1ST ST, 1509, MINNEAPOLIS, MN 55454-1055
(612) 270-0885
Mailing address
1920 S 1ST ST, 1509, MINNEAPOLIS, MN 55454-1055
(612) 270-0885
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2199
MT
122300000X
Dentist
Primary
D12089
MN
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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