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Organization
GARY R. PULFER DDS, PC
Active
Organization
GARY R. PULFER DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY RAY PULFER DDS (PRESIDENT)
(260) 482-4483
Entity
Organization
Contact information
Practice address
1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5831
(260) 482-4483
(260) 471-9889
Mailing address
1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5831
(260) 482-4483
(260) 471-9889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006979
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200829910A
—
IN
Enumeration date
10/09/2006
Last updated
07/08/2008
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