# GARY R. PULFER DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467549600
- **Authorized official:** DR. GARY RAY PULFER DDS (PRESIDENT)
- **Authorized official phone:** (260) 482-4483

## Contact information

- **Practice address:** 1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5831
- **Practice address phone:** (260) 482-4483
- **Practice address fax:** (260) 471-9889
- **Mailing address:** 1405 MEDICAL PARK DR, FORT WAYNE, IN 46825-5831
- **Mailing address phone:** (260) 482-4483
- **Mailing address fax:** (260) 471-9889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12006979 | IN | Yes |

## Other

- **Enumeration date:** 10/09/2006
- **Last updated:** 07/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200829910A | — | IN |