Fuller, C Fredrick
Fuller, C Fredrick is an individual health care provider with primary practice located at 3223 E 29Th St , 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, C Fredrick can be contacted via phone (515) 266-2128.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 5913 | Iowa |
Profile Details
| NPI number | 1902938699 |
|---|---|
| LBN Legal business name | Fuller, C Fredrick |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902938699 | NPPES |
| Iowa | Other | 841112 | UNITED CONCORDIA |
| Iowa | MEDICAID | 0119784 | UNITED CONCORDIA |
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