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1457078677
IAN FULLER
BERKELEY, CA
NPI
1457078677
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA DDS108278)
Enumeration Date
2022-10-27
Last Update Date
2023-11-22
Business Address
Dr. IAN FULLER
1504 ALCATRAZ AVE
BERKELEY, CA 94703-2610
Phone number: 510-653-6424
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Mailing Address
Dr. IAN FULLER
1403 ALLSTON WAY
BERKELEY, CA 94702-1922
Phone number:
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