Provider Demographics
NPI:1154421113
Name:PECHLOFF, JAMES FRANK JR (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:FRANK
Last Name:PECHLOFF
Suffix:JR
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 1:2645 N MAYFAIR RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-475-5505
Mailing Address - Fax:414-475-5829
Practice Address - Street 1:2645 N MAYFAIR RD
Practice Address - Street 2:SUITE 240
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-475-5505
Practice Address - Fax:414-475-5829
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3778015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
392017635OtherEIN