Provider Demographics
NPI:1548222839
Name:PFANNENSTIEL, TERESA YILDIZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:YILDIZ
Last Name:PFANNENSTIEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3242
Mailing Address - Country:US
Mailing Address - Phone:210-326-7698
Mailing Address - Fax:
Practice Address - Street 1:1109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3242
Practice Address - Country:US
Practice Address - Phone:210-326-7698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics