Fuller-Edmonds, Carole

Fuller-Edmonds, Carole is an individual health care provider with primary practice located at 201 N Main St Suite J, Boaz AL 35957-1601. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Fuller-Edmonds, Carole can be contacted via phone (256) 593-0035.

Contact Information

Primary practice address
201 N Main St Suite J Boaz AL 35957-1601
Phone: (256) 593-0035
Fax: (256) 593-9101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 4276 Alabama
Dental Providers / General Practice 1223G0001X 4276 AL Alabama

Profile Details

NPI number 1144296302
LBN Legal business name Fuller-Edmonds, Carole
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Jun 27th, 2023 - about 3 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 1144296302 NPPES
Tennessee Other 135433 BCBS-DENTAL
Tennessee Other 51090809 BCBS-DENTAL
Tennessee MEDICAID 009006500 BCBS-DENTAL
Tennessee Other 630980899 BCBS-DENTAL
Tennessee Other 887635 BCBS-DENTAL

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