Fuller, Adam Fredrick

Fuller, Adam Fredrick is an individual health care provider with primary practice located at 3223 E 29Th Street , Des Moines IA 50317. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Fuller, Adam Fredrick can be contacted via phone (515) 266-2128.

Contact Information

Primary practice address
3223 E 29Th Street Des Moines IA 50317
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 08213 Iowa

Profile Details

NPI number 1578688545
LBN Legal business name Fuller, Adam Fredrick
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578688545 NPPES
Iowa Other 1649447 UNITED CONCORDIA
Iowa MEDICAID 0421883 UNITED CONCORDIA

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