| NPI | 1316234735 |
|---|---|
| Doing Business As | JACK EHLEN, DDS & JULIE FULLER, DDS |
| Entity Type | Organization |
| Authorized Contact | JULIE FULLER Dentist/Owner 253-848-4597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA de60100274) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA de00006157) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |