# DR. TERRELL FRED PANNKUK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1093925323
- **Gender:** Man
- **Credential:** D.D.S., M.SC.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 32445 | CA | Yes |

## Other

- **Enumeration date:** 05/23/2007
- **Last updated:** 09/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | U4632 | — | CA |