Provider Demographics
NPI:1992826234
Name:PULIDO, ELIZABETH H (DDS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:H
Last Name:PULIDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 ADDISON DR NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3439
Mailing Address - Country:US
Mailing Address - Phone:727-579-1866
Mailing Address - Fax:
Practice Address - Street 1:27001 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 8520
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3402
Practice Address - Country:US
Practice Address - Phone:727-799-0650
Practice Address - Fax:727-797-9273
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN157321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice