Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Michael Fullem, DMD

Individual provider Dentist · NPI 1154706380

Charles Michael Fullem, DMD is a Dentist in Enola, Pennsylvania. Licensed in Missouri and Pennsylvania. Registered with an NPI since 2015.

Licensed in
MO, PA
In the registry since
2015
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

2250 Millennium Way Ste 101
Enola, PA 17025-1488
Phone: (717) 972-0031
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DS040673 (PA)
Dentist Taxonomy 122300000X · Licence 2015022255 (MO)

Record details

NPI number1154706380
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 29, 2015
Last updated in NPPESAugust 28, 2023
Certification dateAugust 28, 2023
Mailing address2250 Millennium Way Ste 101, Enola, PA 17025-1488

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