Provider Demographics
NPI:1568590453
Name:WALTER PFITZINGER DDS #2 PC
Entity Type:Organization
Organization Name:WALTER PFITZINGER DDS #2 PC
Other - Org Name:ACCENT DENTAL CENTER OF CLAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:R
Authorized Official - Last Name:PFITZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-862-2006
Mailing Address - Street 1:141 N MERAMEC AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-862-2006
Mailing Address - Fax:314-862-2003
Practice Address - Street 1:141 N MERAMEC AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3750
Practice Address - Country:US
Practice Address - Phone:314-862-2006
Practice Address - Fax:314-862-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty