MEDICARE: RACHEL B PULLIN, DDS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1225600869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RACHEL B PULLIN, DDS, PC

Provider Business Mailing Address
First Line	:	160 RIDGEWAY DR
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24541-6785
Country	:	US
Telephone Number	:	434-548-8419
Fax Number	:	434-793-8820

Provider Business Practice Location Address
First Line	:	4035 RIVERSIDE DR
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24541-5152
Country	:	US
Telephone Number	:	434-793-2045
Fax Number	:	434-793-8820

Authorized Official
Title or Position	:	OWNER, GENERAL DENTIST
Name	:	DR. RACHEL BRINKLEY PULLIN
Credential	:	DDS
Telephone Number	:	434-548-8419

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	07/13/2021

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