Individual
DR. MICHAEL FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7650 CURRELL BLVD STE 200, WOODBURY, MN 55125-8209
(651) 730-9266
(651) 578-0444
Mailing address
7650 CURRELL BLVD STE 200, WOODBURY, MN 55125-8209
(651) 730-9266
(651) 578-0444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7673
MN
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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