Healthcare Provider Details

I. General information

NPI: 1518064401
Provider Name (Legal Business Name): ROBERT P PULLIAM DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 HILLSBORO PIKE STE. 101
NASHVILLE TN
37215-3381
US

IV. Provider business mailing address

4205 HILLSBORO PIKE STE. 101
NASHVILLE TN
37215-3381
US

V. Phone/Fax

Practice location:
  • Phone: 615-297-8973
  • Fax: 615-297-6603
Mailing address:
  • Phone: 615-297-8973
  • Fax: 615-297-6603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7739
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: