Provider Demographics
NPI:1346786860
Name:REID V. PULLEN, D.D.S., P.C.
Entity Type:Organization
Organization Name:REID V. PULLEN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REID
Authorized Official - Middle Name:
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-529-9029
Mailing Address - Street 1:1770 E LAMBERT RD STE 230
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-8001
Mailing Address - Country:US
Mailing Address - Phone:714-529-9029
Mailing Address - Fax:714-529-9059
Practice Address - Street 1:1770 E LAMBERT RD STE 230
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-8001
Practice Address - Country:US
Practice Address - Phone:714-529-9029
Practice Address - Fax:714-529-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-07
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA463231223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty