Provider Demographics
NPI:1093802878
Name:EGUAIBOR -NWAJEI, EFEMA PAMELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:EFEMA
Middle Name:PAMELA
Last Name:EGUAIBOR -NWAJEI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 SHAW AVE
Mailing Address - Street 2:2ND FLR
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3950
Mailing Address - Country:US
Mailing Address - Phone:559-323-1776
Mailing Address - Fax:
Practice Address - Street 1:1010 SHAW AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3950
Practice Address - Country:US
Practice Address - Phone:559-323-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO225081223G0001X
CA608381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice