Provider Demographics
NPI:1497877823
Name:BUTTERFIELD, PAMELA JENNIE (DDS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JENNIE
Last Name:BUTTERFIELD
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 1:940 CENTRAL AVE N
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-2052
Mailing Address - Country:US
Mailing Address - Phone:253-854-2004
Mailing Address - Fax:253-859-9379
Practice Address - Street 1:940 CENTRAL AVE N
Practice Address - Street 2:SUITE B
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-2052
Practice Address - Country:US
Practice Address - Phone:253-854-2004
Practice Address - Fax:253-859-9379
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000059251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice