Alan K Fulks, D.D.S., M.S.

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Kingsford, MI

NPI 1730101064 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1730101064
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
10791 (MI)
Practice address
405 North Blvd
Kingsford, MI 49802-4413
Phone
(906) 774-8490
Fax
(906) 774-4990
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
10791MIMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10791 MI Yes

Addresses

Primary practice location

405 North Blvd
Kingsford, MI 49802-4413

Mailing address

405 North Blvd
Kingsford, MI 49802-4413
Phone (906) 774-8490

Other providers in Kingsford, MI

All providers in Kingsford, MI · Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.