Provider Demographics
NPI:1396834651
Name:COLLINS, PAMELA TEMPLETON (RDH)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:TEMPLETON
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 MUSEUM RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8373
Mailing Address - Country:US
Mailing Address - Phone:704-832-2357
Mailing Address - Fax:704-832-2396
Practice Address - Street 1:1509 MUSEUM RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8373
Practice Address - Country:US
Practice Address - Phone:704-832-2357
Practice Address - Fax:704-832-2396
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1781124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist