Kelly Grace Fuller, RDH
NPI #1104696152 in Enterprise, Oregon
Provider Information
- NPI Number
- 1104696152
- Entity Type
- Individual
- Name
- Kelly Grace Fuller, RDH
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dental Hygienist
- Credential
- RDH
- Enumeration Date
- Jan 2, 2024
- Last Updated
- Jan 2, 2024
Practice Location
- Address
- 603 MEDICAL PKWY
- City
- Enterprise
- State
- Oregon
- ZIP Code
- 97828-5124
- Phone
- (541) 426-4502
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Hygienist |
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