Provider Demographics
NPI:1467489948
Name:CAIN, PAMELA MATHEWS (DDS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:MATHEWS
Last Name:CAIN
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:PO BOX 3047
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38557-3047
Mailing Address - Country:US
Mailing Address - Phone:931-456-2236
Mailing Address - Fax:931-456-6017
Practice Address - Street 1:15 PARKSIDE PLACE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-8865
Practice Address - Country:US
Practice Address - Phone:931-456-2236
Practice Address - Fax:931-456-6019
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN73471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice