Provider Demographics
NPI:1790789162
Name:PYFER, GARY DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:DAVID
Last Name:PYFER
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 1:330 NW RICHMOND BEACH RD
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3120
Mailing Address - Country:US
Mailing Address - Phone:206-542-7494
Mailing Address - Fax:206-542-7495
Practice Address - Street 1:330 NW RICHMOND BEACH RD
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3120
Practice Address - Country:US
Practice Address - Phone:206-542-7494
Practice Address - Fax:206-542-7495
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5514500Medicaid