Provider Demographics
NPI:1376277616
Name:ACOSTA MEJIA, PAMELA CAROLINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:CAROLINA
Last Name:ACOSTA MEJIA
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 1:3090 HIGHWAY 280 E APT 1510
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2719
Mailing Address - Country:US
Mailing Address - Phone:407-990-0419
Mailing Address - Fax:
Practice Address - Street 1:3325 LORNA RD STE 5
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-5464
Practice Address - Country:US
Practice Address - Phone:205-379-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD-0007088-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice