Provider Demographics
NPI:1770588972
Name:PFITZINGER, WALTER ROBERT (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ROBERT
Last Name:PFITZINGER
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:12 WESTBURY DR
Mailing Address - Street 2:STE D
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2543
Mailing Address - Country:US
Mailing Address - Phone:636-925-2787
Mailing Address - Fax:636-925-2829
Practice Address - Street 1:1500 VANDIVER DR
Practice Address - Street 2:STE 104
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-3932
Practice Address - Country:US
Practice Address - Phone:573-814-1694
Practice Address - Fax:573-814-2845
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2021-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO10435122300000X, 1223X2210X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No1223X2210XDental ProvidersDentistOrofacial Pain