Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK ALAN FULLWILER, DDS
ActiveJACK ALAN FULLWILER, DDS is a Dentist healthcare provider located in COEUR D ALENE, Idaho. NPI 1518095678 is currently active in the NPPES registry. Verify at CMS.
Dentist · COEUR D ALENE, ID
Registration Details
- NPI Number
- 1518095678
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 1, 2007 (19.280673871859 yrs)
- Last Updated
- Jul 8, 2007
- License
-
D1747 (ID)
Practice Information
- Address
-
1223 N GOVERNMENT WAYCOEUR D ALENE, ID, 83814Browse ID providers · Browse ZIP 83814
- Phone
- 2086649225
- Fax
- 2086673699
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in COEUR D ALENE, ID
| Name | Credential | NPI |
|---|---|---|
| DR. KYLE PAUL DOSCH | D.D.S. | 1255328209 |
| BRYAN RADER DRYDEN | DDS | 1487768545 |
| DR. JOSHUA LEVI WILLIAMS | D.M.D. | 1275680811 |
| LOGAN DITTO | DDS | 1013166628 |
| DR. RACHEL B FEHLING | D.M.D. | 1063650240 |
| DR. JUSTIN PERRY RADER | D.D.S. | 1548576879 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.