| Organization Name: | LEE PULLEN |
| NPI Number: | 1063613511 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEE PULLEN (DENTIST OWNER) |
| Mailing Address: | 117 Wood St Water Valley |
| State: | MS US |
| Postal Code: | 389652602 |
| Phone Number: | 6624732296 |
| Fax Number: | |
| NPI Enumeration Date: | 05/31/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |