Provider Demographics
NPI:1548438773
Name:PFENT, ELIZABETH MCKENNA (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MCKENNA
Last Name:PFENT
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 1:4089 TAMIAM TR N
Mailing Address - Street 2:SUITE A101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103
Mailing Address - Country:US
Mailing Address - Phone:239-434-5525
Mailing Address - Fax:239-434-2990
Practice Address - Street 1:4089 TAMIAMI TR N
Practice Address - Street 2:SUITE A101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103
Practice Address - Country:US
Practice Address - Phone:239-434-5525
Practice Address - Fax:239-434-2990
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBM3968041OtherDEA