Provider Demographics
NPI:1962600437
Name:PFISTER, MICHAEL JOHN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:PFISTER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1936
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29633-1936
Mailing Address - Country:US
Mailing Address - Phone:864-624-9229
Mailing Address - Fax:864-624-9595
Practice Address - Street 1:101 FINLEY ST
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1583
Practice Address - Country:US
Practice Address - Phone:864-624-9229
Practice Address - Fax:864-624-9595
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT24141223E0200X
MI29010198021223E0200X
SC44251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics