Provider Demographics
NPI:1477762698
Name:CHAMBERLAND, PAM A (DDS)
Entity Type:Individual
Prefix:
First Name:PAM
Middle Name:A
Last Name:CHAMBERLAND
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 1:1006 COLLOREDO BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2781
Mailing Address - Country:US
Mailing Address - Phone:931-684-9167
Mailing Address - Fax:931-684-9633
Practice Address - Street 1:1006 COLLOREDO BLVD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2781
Practice Address - Country:US
Practice Address - Phone:931-684-9167
Practice Address - Fax:931-684-9633
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN74641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice