Individual
ELIZABETH PFOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4207 GLASS RD NE, CEDAR RAPIDS, IA 52402-2538
(192) 948-1813
(319) 261-8182
Mailing address
4207 GLASS RD NE, CEDAR RAPIDS, IA 52402-2538
(319) 294-8181
(319) 261-8182
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DDS-09682
IA
390200000X
Student in an Organized Health Care Education/Training Program
09682
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDS-09682
STATE LICENSE NUMBER
IA
Enumeration date
02/28/2019
Last updated
07/23/2021
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