Provider Demographics
NPI:1598868465
Name:MACPHERSON, PAMELA ANGEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANGEL
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4033 3RD AVENUE,
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103
Mailing Address - Country:US
Mailing Address - Phone:619-294-9525
Mailing Address - Fax:619-294-4083
Practice Address - Street 1:4033 3RD AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:619-294-9525
Practice Address - Fax:619-294-4083
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513571223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics