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DR. RICHARD CHARLES PFOTENHAUER D.D.S., P.C.

>> Dentist >> Dental Providers

Registrant NPI Number: 1972530178

Individual Registrant:
DR. RICHARD CHARLES PFOTENHAUER D.D.S., P.C.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
823 DELTA AVE  GLADSTONE, MI 49837-1646 US
Tel: 906-428-1325  Fax: --

Contact information for business:
116 N 9TH ST STE B GLADSTONE, MI 49837-1660 US
Tel: 906-428-1325  Fax: --

Registration Information:
NPI: 1972530178
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
MI2901013893

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
EMPLOYER IDENTIFICATION N383575211MI01




HEALTH CARE JOBS MI - Page 1



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