Provider Demographics
NPI:1578692620
Name:SCHMIDT, PAMELA LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LEE
Last Name:SCHMIDT
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 1:4850 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4111
Mailing Address - Country:US
Mailing Address - Phone:916-485-3431
Mailing Address - Fax:
Practice Address - Street 1:4850 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4111
Practice Address - Country:US
Practice Address - Phone:916-485-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice