Provider Demographics
NPI:1659679819
Name:LICHTMAN, PAMELA HERMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:HERMAN
Last Name:LICHTMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1606 HOCKETT RD
Mailing Address - Street 2:SUITE#3 PETER MURCHIE DDS FAMILY AND COSMETIC DENTISTRY
Mailing Address - City:MANAKIN SABOT
Mailing Address - State:VA
Mailing Address - Zip Code:23103-2229
Mailing Address - Country:US
Mailing Address - Phone:804-784-4624
Mailing Address - Fax:804-784-4905
Practice Address - Street 1:1606 HOCKETT RD
Practice Address - Street 2:SUITE#3 PETER MURCHIE DDS FAMILY AND COSMETIC DENTISTRY
Practice Address - City:MANAKIN SABOT
Practice Address - State:VA
Practice Address - Zip Code:23103-2229
Practice Address - Country:US
Practice Address - Phone:804-784-4624
Practice Address - Fax:804-784-4905
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014118371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice