Provider Demographics
NPI:1518064401
Name:PULLIAM, ROBERT P (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:PULLIAM
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 HILLSBORO PIKE
Mailing Address - Street 2:STE. 101
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-3381
Mailing Address - Country:US
Mailing Address - Phone:615-297-8973
Mailing Address - Fax:615-297-6603
Practice Address - Street 1:4205 HILLSBORO PIKE
Practice Address - Street 2:STE. 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3381
Practice Address - Country:US
Practice Address - Phone:615-297-8973
Practice Address - Fax:615-297-6603
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN77391223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics