DR. Ellis Lamar Fuller, D.D.S

NPI #1366466286 in Lake Mary, Florida

Provider Information

NPI Number: 1366466286
Entity Type: Individual
Name: DR. Ellis Lamar Fuller, D.D.S
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S
Enumeration Date: Jul 26, 2006
Last Updated: Jun 26, 2012

Practice Location

Address: 114 TIMBERLACHEN CIR
City: Lake Mary
State: Florida
ZIP Code: 32746-3395
Phone: (407) 330-3801

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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