Provider Demographics
NPI:1417334244
Name:EFEMA PAMELA NWAJEI DDS DENTAL CORPORATION
Entity Type:Organization
Organization Name:EFEMA PAMELA NWAJEI DDS DENTAL CORPORATION
Other - Org Name:A BEAUTIFUL SMILE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EFEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAJEI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-391-6809
Mailing Address - Street 1:6767 N FRESNO ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-3740
Mailing Address - Country:US
Mailing Address - Phone:559-447-3020
Mailing Address - Fax:559-447-3025
Practice Address - Street 1:6767 N FRESNO ST STE 200
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3740
Practice Address - Country:US
Practice Address - Phone:559-447-3020
Practice Address - Fax:559-447-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60838261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental