Individual
DR. SPENCER FULLMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 292-5399
(614) 688-3608
Mailing address
1329 BLUFFTON CT, COLUMBUS, OH 43228-9186
(614) 209-8920
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
RES.3003
OH
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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