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General NPI Number Information
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NPI Number | 1982389144
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Entity Type | Organization
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Legal Business Name | NATHAN PULSIPHER DDS LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 1710 W BROADWAY ST
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City | WEST PLAINS
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State | MO
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Zip | 65775-2246
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Country | US
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Telephone | 417-256-4171
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 645
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City | STOCKTON
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State | MO
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Zip | 65785-0645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN PULSIPHER
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Credential | DDS
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Telephone | 417-955-1418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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