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General NPI Number Information
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NPI Number | 1154712040
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Entity Type | Organization
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Legal Business Name | RANCHO ORAL AND FACIAL SURGERY OF MENIFEE
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 02/12/2015
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Provider Practice Location Address
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Address Line | 29798 HAUN RD STE 309
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City | MENIFEE
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State | CA
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Zip | 92586-6541
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Country | US
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Telephone | 951-672-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 39755 MURRIETA HOT SPRINGS RD B130
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City | MURRIETA
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State | CA
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Zip | 92563-9151
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Country | US
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Telephone | 951-600-7457
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Fax | 951-600-2931
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DAVID ALLEN PULSIPHER
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Credential | DDS, MD
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Telephone | 951-600-7457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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