Provider Demographics
NPI:1497957971
Name:PULIDO, STEVEN RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RICHARD
Last Name:PULIDO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 SAN BRUNO AVE W
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3440
Mailing Address - Country:US
Mailing Address - Phone:650-583-3412
Mailing Address - Fax:650-583-3494
Practice Address - Street 1:931 SAN BRUNO AVE W
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4327
Practice Address - Country:US
Practice Address - Phone:650-583-3412
Practice Address - Fax:650-583-3494
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice