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Active NPI 1053352039 Individual Practitioner Male Practitioner

Dr. Mark Frederick Pultman , DDS

Dentist - General Practice • Bridgeton, MO

Professional Overview & Biography Verified Profile Summary

Dr. Mark Pultman, DDS is a registered healthcare professional specializing in Dentist - General Practice in Bridgeton, MO. Practice services are available at 12758 BOENKER LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12758 Boenker Ln

Bridgeton, MO 630442436

Telephone 3147393300
Fax 3147390005
Associated Practice Facility / Clinic
🏢 Dde Llc Facility NPI 1922123652

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bridgeton, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.5 Yrs
Regional Practice Density
13 Specialists

Practicing in Bridgeton, MO (2113 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MO 11328

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. William Dewert , DMD

Dentist - General Practice

NPI 1083759518

Doctor of Dental Medicine

Christopher Dowling

Dentist - General Practice

NPI 1124015375
NPI 1134019318

Doctor of Dental Medicine

Dr. Terry Egan , DDS

Dentist - Periodontics

NPI 1649395393

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 12758 BOENKER LN, BRIDGETON, MO 630442436 (Tel: 3147393300)

📍
Updated Business Mailing Address July 08, 2007

Registered at 12758 BOENKER LN, BRIDGETON, MO 630442436 (Tel: 3147393300)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MARK PULTMAN, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #11328 in MO)

🟢
Initial NPI Registration & Enumeration June 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053352039
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 09, 2006
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

12758 Boenker Ln

Bridgeton, MO 630442436

Phone: 3147393300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.