Mark Frederick Pultman, D.D.S.

General Practice Dentistry · Bridgeton, MO

Individual Active NPI

NPI number 1053352039

Practice location

12758 Boenker Ln
Bridgeton, MO 63044-2436
Phone
(314) 739-3300
Fax
(314) 739-0005

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NPI record

NPI
1053352039
Entity type
Individual (Type 1)
Enumeration date
June 9, 2006
Last updated
July 13, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 11328 MO

About Dr. Pultman

Mark Frederick Pultman, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 12758 Boenker Ln, Bridgeton, MO 63044-2436. The NPI number 1053352039 was assigned on June 9, 2006 and the record was last updated on July 13, 2026.

Dr. Pultman lists a license in the registry: #11328 (MO) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Frederick Pultman, D.D.S.?

The NPI number is 1053352039.

What is the phone number of Dr. Pultman?

The phone number listed for the practice location is (314) 739-3300.

Where is Dr. Pultman located?

12758 Boenker Ln, Bridgeton, MO 63044-2436.

What is the taxonomy code for Dr. Pultman?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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