Individual
DR. CHARLES FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2301 E VILLA MARIA RD, BRYAN, TX 77802-2550
(979) 776-1838
Mailing address
1077 VENICE DR, BRYAN, TX 77808-7593
(870) 847-4188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38711
TX
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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