MEDICARE: BALSTER & PFOHL PEDIATRIC DENTISTRY LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1538013479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALSTER & PFOHL PEDIATRIC DENTISTRY LLP

Provider Business Mailing Address
First Line	:	4150 EDGEWOOD RD NE STE 250
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-7106
Country	:	US
Telephone Number	:	319-294-8181
Fax Number	:	319-261-8182

Provider Business Practice Location Address
First Line	:	4150 EDGEWOOD RD NE STE 250
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-7106
Country	:	US
Telephone Number	:	319-294-8181
Fax Number	:	319-261-8182

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. ERIK THOMAS BALSTER
Credential	:	DDS
Telephone Number	:	319-270-4339

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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