Provider Demographics
NPI:1609109115
Name:PFISTER, NATHAN E (DDS)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:E
Last Name:PFISTER
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 1:200 PARKWEST CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-3069
Mailing Address - Country:US
Mailing Address - Phone:334-446-3211
Mailing Address - Fax:
Practice Address - Street 1:200 PARKWEST CIR STE 1
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-3069
Practice Address - Country:US
Practice Address - Phone:855-939-5566
Practice Address - Fax:334-446-3215
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6175122300000X
HI2389122300000X
AL59747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist