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FULLWOOD DENTAL CLINIC, LLC
NPI 1881021020
Dentist - General Practice in Selmer, TN

Active since October 02, 2013
485 MULBERRY AVE, SELMER, TN 38375(731) 645-7785 Get Directions Write a Review

NPPES record last updated: October 2, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fullwood Dental Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FULLWOOD DENTAL CLINIC, LLC (NPI 1881021020) is a healthcare organization registered as a general practice in Selmer, Tennessee and active in the NPI registry since October 2013. The organization lists Ronnie L Fullwood, Dentist, as its authorized official.

NPPES Registry Identity

NPI1881021020
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameFULLWOOD DENTAL CLINIC, LLC
Location Address485 MULBERRY AVESelmer, TN 38375-2307
Mailing Address485 Mulberry AveSelmer, TN 38375-2307 · (731) 645-7785
Phone(731) 645-7785
Organization SubpartNo
Authorized OfficialRonnie L FullwoodDentist · (731) 645-7785
Enumeration DateOctober 2, 2013
✔ NPI 1881021020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TN · 9500
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
485 MULBERRY AVE, Selmer, TN 38375
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PATRICK LEE FULLWOOD D.D.S.
Dentist
485 MULBERRY AVE
SELMER, TN 38375
McNairy County (731) 645-7785
DR. REID VINSON DDS
Dentist (General Practice)
485 MULBERRY AVE
SELMER, TN 38375
McNairy County (731) 645-7785

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fullwood Dental Clinic, LLC's NPI number?

The NPI number for Fullwood Dental Clinic, LLC is 1881021020. It was assigned to this organization in the NPPES registry on October 2, 2013.

Where is Fullwood Dental Clinic, LLC located?

Fullwood Dental Clinic, LLC is located at 485 Mulberry Ave, Selmer, TN 38375. The listed phone number is (731) 645-7785.

What is Fullwood Dental Clinic, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Fullwood Dental Clinic, LLC was last updated on October 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.