| Gary R. Pulfer Dds, Pc | |
|
1405 Medical Park Dr Fort Wayne IN 46825-5831 | |
| (260) 482-4483 | |
| (260) 471-9889 |
| Full Name | Gary R. Pulfer Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1405 Medical Park Dr, Fort Wayne, Indiana |
| Authorized Official Name and Position | Gary Ray Pulfer (PRESIDENT) |
| Authorized Official Contact | 2604824483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary R. Pulfer Dds, Pc 1405 Medical Park Dr Fort Wayne IN 46825-5831 Ph: (260) 482-4483 | Gary R. Pulfer Dds, Pc 1405 Medical Park Dr Fort Wayne IN 46825-5831 Ph: (260) 482-4483 |
| NPI Number | 1467549600 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467549600 | NPI | - | NPPES |
| 200829910A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12006979 (Indiana) | Primary |
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