Provider Demographics
NPI:1942413661
Name:PFOHL, CHAD MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MICHAEL
Last Name:PFOHL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2814 NORTHGATE DR.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9568
Mailing Address - Country:US
Mailing Address - Phone:319-338-5484
Mailing Address - Fax:319-338-9413
Practice Address - Street 1:2814 NORTHGATE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9513
Practice Address - Country:US
Practice Address - Phone:319-338-5484
Practice Address - Fax:319-338-9413
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA084591223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery