Individual provider · Type 1 NPI

Kelly Grace Fuller, RDH

Dental Hygienist · Enterprise, OR

NPI number 1104696152 Active

Practice location

603 Medical Pkwy
Enterprise, OR 97828-5124

Call (541) 426-4502 Map

Fax (541) 426-6403

Specialties and licenses

TaxonomyCodeLicense
Dental Hygienist Primary 124Q00000XH8509 (OR)

Dental Hygienist: An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and…

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About NPI 1104696152

Kelly Grace Fuller, RDH's National Provider Identifier is 1104696152, issued on Jan 2, 2024. The primary taxonomy on file is Dental Hygienist (124Q00000X), and the practice location is in Enterprise, OR. The record was last updated on Jan 2, 2024.