Provider Demographics
NPI:1467526434
Name:DOUGLAS A PULSIPHER DDS PLLC
Entity Type:Organization
Organization Name:DOUGLAS A PULSIPHER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PULSIPHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-706-0789
Mailing Address - Street 1:4350 E RAY RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044
Mailing Address - Country:US
Mailing Address - Phone:480-706-0789
Mailing Address - Fax:480-706-4607
Practice Address - Street 1:4350 E RAY RD
Practice Address - Street 2:SUITE 116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044
Practice Address - Country:US
Practice Address - Phone:480-706-0789
Practice Address - Fax:480-706-4607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty