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General NPI Number Information
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NPI Number | 1437350766
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Entity Type | Organization
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Legal Business Name | ROBERT F. FULMER, D.D.S., P.A.
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1604 E MOORE AVE
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City | SEARCY
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State | AR
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Zip | 72143-4633
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Country | US
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Telephone | 501-268-1831
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Fax | 501-268-3097
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Provider Business Mailing Address
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Address Line | 1604 E MOORE AVE
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City | SEARCY
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State | AR
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Zip | 72143-4633
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Country | US
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Telephone | 501-268-1831
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Fax | 501-268-3097
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT FULMER
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Credential | D,D.S.
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Telephone | 501-268-1831
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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 | 2450
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License Number State | AR
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