Provider Demographics
NPI:1164400669
Name:PFEFFLE, ROBERT C (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:PFEFFLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 GRELOT RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3603
Mailing Address - Country:US
Mailing Address - Phone:251-344-6191
Mailing Address - Fax:251-344-6794
Practice Address - Street 1:5901 GRELOT RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-3603
Practice Address - Country:US
Practice Address - Phone:251-344-6191
Practice Address - Fax:251-344-6794
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL45981223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL32729OtherBCBS PROVIDER
AL969905OtherUNITED CONCORDIA
ALU67336Medicare UPIN