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General NPI Number Information
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NPI Number | 1558564518
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Entity Type | Organization
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Legal Business Name | TEMECULA VALLEY FACIAL & ORAL SURGERY CENTER
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 02/14/2013
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Provider Practice Location 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 | 92563-9101
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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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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 | 92563-9101
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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 | OWNER
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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 | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | A67982
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License Number State | CA
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