Jon Gordon Fuller Jr., D.D.S.

General Practice Dentistry · Moab, UT

Individual Active NPI

NPI number 1376566976

Practice location

570 W 400 N
Moab, UT 84532-2236
Phone
(435) 259-4333
Fax
(435) 259-6618

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NPI record

NPI
1376566976
Entity type
Individual (Type 1)
Enumeration date
July 25, 2006
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 142288-9921 UT

About Dr. Fuller

Jon Gordon Fuller Jr., D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 570 W 400 N, Moab, UT 84532-2236. The NPI number 1376566976 was assigned on July 25, 2006 and the record was last updated on July 8, 2007.

Dr. Fuller lists a license in the registry: #142288-9921 (UT) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jon Gordon Fuller Jr., D.D.S.?

The NPI number is 1376566976.

What is the phone number of Dr. Fuller?

The phone number listed for the practice location is (435) 259-4333.

Where is Dr. Fuller located?

570 W 400 N, Moab, UT 84532-2236.

What is the taxonomy code for Dr. Fuller?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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