Provider Demographics
NPI:1992363188
Name:PULFER, FALON (DDS)
Entity Type:Individual
Prefix:
First Name:FALON
Middle Name:
Last Name:PULFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:FALON
Other - Middle Name:
Other - Last Name:GOETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2220 N NYE AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2220 N NYE AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2543
Practice Address - Country:US
Practice Address - Phone:402-721-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7533122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist