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David James Fulton, DDS Valid NPI

Individual provider · General Practice Dentistry · Waukegan, IL

NPI
1518030519
Type
Individual (Type 1)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
019020827 (IL)
Sex
Male
Sole proprietor
No
Enumerated
2006-11-16
Last updated
2012-04-24
Practice location
1308 Sunset Ave
Waukegan, IL 60087-4836
(847) 249-2621

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