Shane Alan Fuller, D.D.S.

NPI #1326450867 in Spring Valley, California

Provider Information

NPI Number: 1326450867
Entity Type: Individual
Name: Shane Alan Fuller, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jun 2, 2014
Last Updated: Mar 17, 2018

Practice Location

Address: 8788 JAMACHA RD
City: Spring Valley
State: California
ZIP Code: 91977-4035
Phone: (619) 515-2555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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