Individual
DR. ROBERT B PULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 WASHINGTON AVE, NIAGARA, WI 54151
(715) 251-1486
Mailing address
PO BOX 23, 621 WASHINGTON AVE, NIAGARA, WI 54151
(715) 251-1486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3804
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33496400
—
WI
Enumeration date
04/11/2007
Last updated
07/08/2007
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