DR. Mark Crandall Fullmer, DDS

NPI #1568684470 in Springville, Utah

Provider Information

NPI Number
1568684470
Entity Type
Individual
Name
DR. Mark Crandall Fullmer, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist
Credential
DDS
Enumeration Date
May 2, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
225 EAST 400 SOUTH
State
Utah
ZIP Code
84663
Phone
(801) 489-3611

Specialties & Taxonomy Codes

Specialty
Dentist

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