Provider Demographics
NPI:1558970590
Name:PASTOOR, CHAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:PASTOOR
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 1:8224 GREEN HOPE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1577
Mailing Address - Country:US
Mailing Address - Phone:336-601-5811
Mailing Address - Fax:
Practice Address - Street 1:515 KEISLER DR STE 204
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7097
Practice Address - Country:US
Practice Address - Phone:919-859-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC119831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice