Provider Demographics
NPI:1376768473
Name:DISSE PFEIFER, SCARLET (DDS)
Entity Type:Individual
Prefix:
First Name:SCARLET
Middle Name:
Last Name:DISSE PFEIFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6979S HOLLY CIRCLE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6253
Mailing Address - Country:US
Mailing Address - Phone:303-850-7614
Mailing Address - Fax:303-770-3482
Practice Address - Street 1:6979S HOLLY CIRCLE
Practice Address - Street 2:SUITE 150
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6253
Practice Address - Country:US
Practice Address - Phone:303-850-7614
Practice Address - Fax:303-770-3482
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist