Individual
DR. RICHARD CHARLES PFOTENHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., P.C.
Contact information
Practice address
823 DELTA AVE, GLADSTONE, MI 49837-1646
(906) 428-1325
Mailing address
116 N 9TH ST, STE B, GLADSTONE, MI 49837-1660
(906) 428-1325
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901013893
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383575211
EMPLOYER IDENTIFICATION N
MI
Enumeration date
06/26/2006
Last updated
09/20/2016
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