Provider Demographics
NPI:1396434791
Name:PFEUFFER, JODY ALLISON (DMD)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:ALLISON
Last Name:PFEUFFER
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 1:1000 FM 300
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6235
Mailing Address - Country:US
Mailing Address - Phone:806-894-7842
Mailing Address - Fax:806-300-8650
Practice Address - Street 1:1502 N AVENUE K
Practice Address - Street 2:
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-3040
Practice Address - Country:US
Practice Address - Phone:806-872-6310
Practice Address - Fax:806-403-3122
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX396011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice