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General NPI Number Information
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NPI Number | 1306732763
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Entity Type | Organization
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Legal Business Name | FULLER & ASSOCIATES 13, PLLC
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Dates
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Enumeration Date | 06/13/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 655 SW BROAD ST
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-5925
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Country | US
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Telephone | 910-692-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 FORESTDALE DR
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City | BURLINGTON
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State | NC
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Zip | 27215-9142
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Country | US
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Telephone | 336-586-5012
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CHAD RUMLEY
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Credential |
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Telephone | 336-586-5012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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