| Fullwood Dental Clinic, Llc | |
|
485 Mulberry Ave Selmer TN 38375-2307 | |
| (731) 645-7785 | |
| Not Available |
| Full Name | Fullwood Dental Clinic, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 485 Mulberry Ave, Selmer, Tennessee |
| Authorized Official Name and Position | Ronnie L Fullwood (DENTIST) |
| Authorized Official Contact | 7316457785 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fullwood Dental Clinic, Llc 485 Mulberry Ave Selmer TN 38375-2307 Ph: (731) 645-7785 | Fullwood Dental Clinic, Llc 485 Mulberry Ave Selmer TN 38375-2307 Ph: (731) 645-7785 |
| NPI Number | 1881021020 |
|---|---|
| Provider Enumeration Date | 10/02/2013 |
| Last Update Date | 10/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881021020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9500 (Tennessee) | Primary |
Wilson Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Federal Dr, Selmer, TN 38375 Phone: 731-645-7506 Fax: 731-645-5660 | |
Selmer Smiles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 718 Federal Dr, Selmer, TN 38375 Phone: 731-645-3291 Fax: 731-645-3299 | |
Dr. Greg L. Wilson Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Federal Dr, Selmer, TN 38375 Phone: 731-645-7506 Fax: 731-645-5660 |