Provider Demographics
NPI:1285223487
Name:FULLER & ASSOCIATES VIII PLLC
Entity Type:Organization
Organization Name:FULLER & ASSOCIATES VIII PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:SPHR
Authorized Official - Phone:336-586-5012
Mailing Address - Street 1:3450 FORESTDALE DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9142
Mailing Address - Country:US
Mailing Address - Phone:336-586-5010
Mailing Address - Fax:336-586-5015
Practice Address - Street 1:103 GANYARD FARM WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-6230
Practice Address - Country:US
Practice Address - Phone:919-957-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty