NPI
Mark Crandall Fullmer
NPI 1568684470
Read from the NPPES registry on October 25, 2026.
Facts
- Status
- Active
- Credential
- DDS
- Type
- Individual
- Enumeration date
- 2007-05-02
- Last updated
- 2007-07-08
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Specialties
Licenses
- License UT
- 143367-9921
Location
- Practice location
- 225 East 400 South
- City
- Springville UT
- Postal code
- 84663
- Phone
- (801) 489-3611
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Dentists in Springville, UT. 9 with this primary taxonomy in the public file.
Other NPIs in Springville, UT. 543 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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