Michael Kent Fulton, D.D.S.

Key facts

NPI

1497820922

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

Practice address

2102 W Randolph St
Vandalia, IL 62471-1973

Phone

(618) 283-4900

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 2102 Randolph Vandalia Professional, LLC General Practice Dentistry · Vandalia, IL · NPI 1588532675
  NPD (past) GENERAL PRACTICE
• Dynamic Dental Group, P.C. General Practice Dentistry · Vandalia, IL · NPI 1811062557
  NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

Other providers in Vandalia, IL

• Tina Fischer
• Callie Fleshren, DMD
• Heather Kay Foley, D.C.
• Brent Frey, PHARMD
• Barbara L Fuessel, F.N.P./R.N.
• Richard Dean Funneman, MD
• Lynette Marie Gartke, L.C.P.C.
• Matthew Gerald Gartke, L.C.P.C.
• Lacey Glynn
• Granite City Orthopedic Physicians Company LLC

All providers in Vandalia, IL · General Practice Dentistry in Illinois