Dr. Larry Fuller III, DDS
Dentist in Drumright, OK. Individual provider (NPI-1).
NPI number1730872011
StatusActive
Last updated in NPPESJun 1, 2023
Details
- NPI
- 1730872011
- Entity type
- Individual (NPI-1)
- Name
- Dr. Larry Fuller III
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2023
- Certification date
- Jun 1, 2023
- Last updated
- Jun 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 7702 | OK | Yes |
Practice location
1226 W Broadway StDrumright, OK 74030-5826
Phone 918-352-3312
Mailing address
1226 W Broadway StDrumright, OK 74030-5826
Phone 918-352-3312
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