Provider Demographics
NPI:1235158916
Name:PFAHLER, DONALD (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:PFAHLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 ODANA RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1238
Mailing Address - Country:US
Mailing Address - Phone:608-274-5970
Mailing Address - Fax:608-274-0158
Practice Address - Street 1:5709 ODANA RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1238
Practice Address - Country:US
Practice Address - Phone:608-274-5970
Practice Address - Fax:608-274-0158
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50010561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice