Provider Demographics
NPI:1093920423
Name:BELL, PAMELA BERKE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:BERKE
Last Name:BELL
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 1:401 MAPLEWOOD DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5849
Mailing Address - Country:US
Mailing Address - Phone:561-747-8808
Mailing Address - Fax:
Practice Address - Street 1:401 MAPLEWOOD DR
Practice Address - Street 2:SUITE 9
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5849
Practice Address - Country:US
Practice Address - Phone:561-747-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10447122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist