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General NPI Number Information
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NPI Number | 1275759813
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Entity Type | Organization
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Legal Business Name | DONALD J. PFOTENHAUER DDS PC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2500 7TH AVE S DOCTORS PARK SUITE 216
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City | ESCANABA
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State | MI
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Zip | 49829-1176
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Country | US
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Telephone | 906-789-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 7TH AVE S DOCTORS PARK SUITE 216
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City | ESCANABA
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State | MI
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Zip | 49829-1176
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Country | US
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Telephone | 906-789-9400
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DONALD PFOTENHAUER JR.
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Credential | DDS
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Telephone | 906-789-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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