Mark Frederick Pultman, D.D.S. Valid NPI
Individual provider · General Practice Dentistry · Bridgeton, MO
- NPI
- 1053352039
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 11328 (MO)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-06-09
- Last updated
- 2007-07-08
Practice location
12758 Boenker Ln
Bridgeton, MO 63044-2436
(314) 739-3300