Provider Demographics
NPI:1346750346
Name:JOSEPH B. FULTON, D.D.S., CASCADES DENTAL GROUP, INC.
Entity Type:Organization
Organization Name:JOSEPH B. FULTON, D.D.S., CASCADES DENTAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-423-1975
Mailing Address - Street 1:1725 WESTERN AVE STE D
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1345
Mailing Address - Country:US
Mailing Address - Phone:419-423-1975
Mailing Address - Fax:419-423-1983
Practice Address - Street 1:1725 WESTERN AVE STE D
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1345
Practice Address - Country:US
Practice Address - Phone:419-423-1975
Practice Address - Fax:419-423-1983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental