Healthcare Provider Details

I. General information

NPI: 1346786860
Provider Name (Legal Business Name): REID V. PULLEN, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2017
Last Update Date: 01/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 E LAMBERT RD STE 230
BREA CA
92821-8001
US

IV. Provider business mailing address

1770 E LAMBERT RD STE 230
BREA CA
92821-8001
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-9029
  • Fax: 714-529-9059
Mailing address:
  • Phone: 714-529-9029
  • Fax: 714-529-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number46323
License Number StateCA

VIII. Authorized Official

Name: DR. REID PULLEN
Title or Position: OWNER
Credential: D.D.S.
Phone: 714-529-9029