Jack Alan Fullwiler is a Coeur D Alene, Idaho based Dentist who is specialized in Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Jack Alan Fullwiler is D1747 for Dentistry in Idaho. His current practice location is 1223 N Government Way, Coeur D Alene. Patients can reach him at 208-664-9225.
Jack Alan Fullwiler is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Jack Alan Fullwiler speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Jack Alan Fullwiler
Specialization:
Dentist
Gender:
Male
Credentials:
DDS
Accepts Medicare Assignment:
No
Practice Address:
1223 N Government Way, Coeur D Alene, Idaho, 83814
Phone:
208-664-9225
Fax:
208-667-3699
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1518095678
NPI Enumeration Date:
01 Mar, 2007
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jack Alan Fullwiler are as mentioned below.
License Number
Specialization
State
Status
D1747
Dentistry
Idaho
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Jack Alan Fullwiler such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
000010009552
Other
REGENCE BLUE SHIELD
07068
Other
WASHINGTON DENT SERV
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1223 N Government Way, Coeur D Alene, Idaho
Zip:
83814
Phone Number:
208-664-9225
Fax Number:
208-667-3699
Patients can reach Jack Alan Fullwiler at 1223 N Government Way, Coeur D Alene, Idaho or can call to book an appointment on 208-664-9225. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.