Individual
DR. CLAYTON SCOTT FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
589 3RD AVE, CHULA VISTA, CA 91910-5619
(619) 422-3223
(619) 422-7777
Mailing address
589 3RD AVE, CHULA VISTA, CA 91910-5619
(619) 422-3223
(619) 422-7777
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34101
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B34101-01
DENTI-CAL
CA
Enumeration date
02/26/2007
Last updated
07/08/2007
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