Brad T Fulkerson, DMD,MSD,LLC

Organization Active NPI Pediatric Dentistry · Henderson, KY

NPI 1730457763 · NPPES record last updated Dec 5, 2011

Key facts

NPI
1730457763
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
License
7040 (KY)
Legal business name
BRAD T FULKERSON, DMD,MSD,LLC
Practice address
700A Barrett Blvd
Henderson, KY 42420-4931
Phone
(270) 827-5522
Fax
(270) 827-8272
NPI assigned
Dec 5, 2011
Organization subpart
No

Authorized official

Name
Dr. Brad Todd Fulkerson, DMD
Title
Owner
Phone
(270) 827-5522

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

700 Barret Blvd
Ste A
Henderson, KY 42420
Phone (270) 827-5522

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
122300000X 12009862 IN
Pediatric Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223P0221X 7040 KY Yes

Addresses

Primary practice location

700A Barrett Blvd
Henderson, KY 42420-4931

Mailing address

700A Barrett Blvd
P.O. Box 276
Henderson, KY 42420-4931
Phone (270) 827-5522

Other providers in Henderson, KY

All providers in Henderson, KY · Pediatric Dentistry in Kentucky

Sources for this page

Verify at the official NPI Registry.