Provider Demographics
NPI:1770733578
Name:PFARRER-DAZEN, ANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:PFARRER-DAZEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-2039
Mailing Address - Country:US
Mailing Address - Phone:609-267-7323
Mailing Address - Fax:609-267-8744
Practice Address - Street 1:120 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-2039
Practice Address - Country:US
Practice Address - Phone:609-267-7323
Practice Address - Fax:609-267-8744
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI016147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist