Provider Demographics
NPI:1700222783
Name:RANCHO ORAL AND FACIAL SURGERY INC A DENTAL PRACTICE OF D ALLEN PULSIP
Entity Type:Organization
Organization Name:RANCHO ORAL AND FACIAL SURGERY INC A DENTAL PRACTICE OF D ALLEN PULSIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PULSIPHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:951-600-7457
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:B130
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9151
Mailing Address - Country:US
Mailing Address - Phone:951-600-7457
Mailing Address - Fax:
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:B130
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9151
Practice Address - Country:US
Practice Address - Phone:951-600-7457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty