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1134245053
RONALD RAY FULKERSON
BLOOMINGTON, IN
NPI
1134245053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 12007022A)
Enumeration Date
2007-03-22
Last Update Date
2007-07-08
Business Address
Dr. RONALD RAY FULKERSON D.D.S.
3929 E 3RD ST SUITE 4
BLOOMINGTON, IN 47401-5554
Phone number: 812-336-3057
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Mailing Address
Dr. RONALD RAY FULKERSON D.D.S.
3929 E 3RD ST SUITE 4
BLOOMINGTON, IN 47401-5554
Phone number: 812-336-3057
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