Provider Demographics
NPI:1386986800
Name:DAVID E PULGINI PC
Entity type:Organization
Organization Name:DAVID E PULGINI PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PULGINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-363-5388
Mailing Address - Street 1:415 W COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3922
Mailing Address - Country:US
Mailing Address - Phone:248-363-5388
Mailing Address - Fax:248-363-5606
Practice Address - Street 1:415 W COMMERCE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3922
Practice Address - Country:US
Practice Address - Phone:248-363-5388
Practice Address - Fax:248-363-5606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901012834122300000X
MI2901019208122300000X
MI2901018679122300000X
MI2901019649122300000X
MI2901019227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty