Individual
HAYDEN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120-8386
(405) 755-4826
Mailing address
2141 HUNTLEIGH DR, OKLAHOMA CITY, OK 73120-3806
(405) 414-7481
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6853
OK
1223P0300X
Periodontics
Primary
81
OK
Other
Enumeration date
07/02/2018
Last updated
02/09/2021
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