Provider Demographics
NPI:1518002500
Name:PULVER, KIM KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:KEVIN
Last Name:PULVER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19365 7TH AVE NE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7441
Mailing Address - Country:US
Mailing Address - Phone:360-697-5818
Mailing Address - Fax:360-697-6400
Practice Address - Street 1:19365 7TH AVE NE
Practice Address - Street 2:SUITE 106
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7441
Practice Address - Country:US
Practice Address - Phone:360-697-5818
Practice Address - Fax:360-697-6400
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice