Dr. Elisabeth Rebecca Fulling, D.D.S.
Dentist, General Practice in Minneapolis, MN. Individual provider (NPI-1).
NPI number1487945697
StatusActive
Last updated in NPPESMay 8, 2014
Details
- NPI
- 1487945697
- Entity type
- Individual (NPI-1)
- Name
- Dr. Elisabeth Rebecca Fulling
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2011
- Last updated
- May 8, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D13337 | MN | Yes |
Practice location
701 Park AveDepartment Of Dentistry
Minneapolis, MN 55415-1623
Phone 612-873-6275
Mailing address
701 Park AveDepartment Of Dentistry
Minneapolis, MN 55415-1623
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