MEDICARE: DR. ANTHONY MICHAEL PULVER D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12012413A	IN

General Provider Information

NPI Number	:	1346616679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY MICHAEL PULVER D.M.D.

Provider Business Mailing Address
First Line	:	501 E COMMERCIAL AVE
Second Line	:
City	:	LOWELL
State	:	IN
Zip	:	46356-1816
Country	:	US
Telephone Number	:	219-696-4940
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 E COMMERCIAL AVE
Second Line	:
City	:	LOWELL
State	:	IN
Zip	:	46356-1816
Country	:	US
Telephone Number	:	219-696-4940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2015
Last Update Date	:	08/20/2015

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Directions to “ DR. ANTHONY MICHAEL PULVER D.M.D.” Practice Location

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